Healthcare Executives Address Industry Challenges, Issues, & Opportunities2019 Annual Forum of the HealthCare Executive Group (HCEG). Ideas, 'Best Practices' and lessons learned. Intimate venue insight, ideas, and actionable information. 2020 HCEG Top 10 list.

Healthcare Executives Address Industry Challenges, Issues, & Opportunities in Boston on September 9th

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The 2019 Annual Forum of the HealthCare Executive Group (HCEG) takes place in HCEG’s birthplace – Boston, Massachusetts – on September 9th.  Just over 30 years ago, a group of healthcare executives created the Managed Care Executive Group (MCEG), a ‘user group’ to share their ideas, ‘Best Practices’ and lessons learned. These healthcare leaders recognized the value of collaborating with like-minded individuals to solve challenges, deal with similar issues, and leverage opportunities together. Fast forward about 20 years and the Managed Care Executive Group became the HealthCare Executive Group. And in less than two months, the HealthCare Executive Group returns to its birthplace in Boston for its 31st Annual Forum!

Our annual forum planning team is pleased to share that the 2019 Annual Forum is shaping up to be one of our best forums ever. Three keynotes from prominent healthcare industry leaders with interactive sessions set in an intimate venue provide insight, ideas, and actionable information. The development of the 2020 HCEG Top 10 list enables all forum participants to have a role in identifying and ranking the challenges, issues, and opportunities they’re facing in today’s uncertain and rapidly transforming healthcare industry. And two unique networking events offer the opportunity for attendees to grow and expand their professional and personal networks.Healthcare Executives Address Industry Challenges, Issues, & Opportunities2019 Annual Forum of the HealthCare Executive Group (HCEG). Ideas, 'Best Practices' and lessons learned. Intimate venue insight, ideas, and actionable information. 2020 HCEG Top 10 list.

Keynotes by Healthcare Industry Leaders

The DC Landscape: Policy Poised to Impact Health Plans in the Near Term

Matt Eyles, President & CEO of America’s Health Insurance Plans (AHIP), will open the forum with an overview of the legislative and political landscape in Washington, D.C. Attendees will gain insights to help them:

  • Cut through the noise in the upcoming election year
  • Learn which policies may directly impact healthcare businesses and members in the next year
  • Explore top-of-mind issues including the future of Medicare and the ACA, as well as bipartisan agreements to reduce the price of prescription drugs
  • Consider new ways to keep costs down and simplify the healthcare system for members

Knowledge is Power: Cost Transparency as a Shared Strength and Responsibility

Niall Brennan, former Chief Data Officer at the Centers for Medicare & Medicaid Services (CMS) and current President & CEO of Health Care Cost Institute (HCCI), shares insight into how healthcare organizations collaborate to enable best-in-class data sets to provide greater value through transparency. Niall will share how:

  • to understand cost and utilization trends in the commercially insured population
  • to delve into the issue of cost variation in the US market and how it impacts the transparency movement at the regulatory level
  • HCCI and health plans work together to share de-identified cost and outcome data, help their members navigate cost more easily and drive improvement in quality and value with robust analytics
  • healthcare plans, health systems, provider organizations AND members, patients, and consumers can both benefit from and help fuel the transparency mission

The Changing Landscape and the Politics of Healthcare

While unable to share confirmed details about the keynote speaker, HCEG is working with two Massachusetts healthcare industry leaders with the expectation one or both of them will share their valued perspective on the changing landscape and political uncertainties impacting the healthcare industry. This keynote address will take place over dinner on the second day of the 2019 Annual Forum. We’re hopeful the schedule of the speaker we’re working with supports their ability to share their insight unique and ideas with the healthcare executive attendees of our 2019 Annual Forum.

Interactive Sessions

This year’s Annual Forum includes eight presentations/panelist sessions addressing challenges, issues, and opportunities facing today’s healthcare leaders. HCEG sessions aim to enable significant interaction opportunities for our annual speakers, panelists, attendees, and all others involved to be able to network and share their respective thoughts and needs.  A few of the sessions we’re developing to promote information exchange and networking opportunities include:

Digital Transformation: How Novel Technologies are Making a Tangible Impact

Healthcare Executives Address Industry Challenges, Issues, & Opportunities 2019 Annual Forum of the HealthCare Executive Group (HCEG). Ideas, 'Best Practices' and lessons learned. Intimate venue insight, ideas, and actionable information. 2020 HCEG Top 10 list.

Panelists will present and discuss use cases of disruptive digital health innovation and attendees will…

  • Hear first-hand examples of how technology successfully integrates into organizational workflow
  • Learn of short and long-term impacts on their business, relationships with other stakeholders, and consumers.
  • Better understand which technologies foster engagement between health care stakeholders
  • Be able to assess the impact of disruptive digital health innovation on consumers, patients, outcomes, and costs

Beyond the Trend: Follow the Money to Identify Technologies Defining the Future of Healthcare

This panel of experts discusses the merger and acquisitions (M&A) landscape with a focus on technology investment.  Attendees will…

  • Gain insight into which advancements investors are betting on and why
  • What’s driving the investment community toward M&A, and how the right technology factors into the decision to invest in a business or not
  • Learn about top technologies poised to meaningfully support healthcare payment and delivery transformation in the next 3 years

Developing a Collaborative Approach to Address the Opioid Crisis

In this panel, experts discuss the current state of the opioid crisis and explore collaborative strategies for better managing the current opioid crisis:

  • Strategies in play today that aim to prevent and treat opioid abuse including progress to-date and lessons learned during their implementation
  • Next steps to move the needle in a positive direction including which efforts are making the most impact
  • How healthcare organizations can collaborate to mitigate the opioid epidemic on a local and national level

Quizzify: So, You Think You Know Healthcare?

An interactive, fun, and compelling ‘Quizzify session’ led by Al Lewis, President of Quizzify, will help forum participants learn just how much they DO NOT KNOW about healthy behavior. This live quiz simulates an approach many employers are using to teach employees how to make healthier decisions and spend healthcare dollars more wisely. We think this will be an enlightening session.

2020 HCEG Top 10: Voting and Ranking

Over the last decade, a highlight of the HealthCare Executive Group’s annual forum is the development of the HCEG Top 10 list of challenges, issues, and opportunities currently faced by healthcare executives. Starting with a list of 25-30 items identified by HCEG members and sponsor partners, forum participants interact with each other to identify the top 10 challenges, issues and opportunities facing their organizations. After interactive discussion in roundtable format over lunch, forum participants rank the items to create the 2020 HCEG Top 10 list.HCEG Top 10. Industry Pulse Survey. Challenges, issues, opportunities healthcare industry. Data & Analytics, Total Consumer Health, Population Health Services, Value-based Payments, The Digital Healthcare Organization, Rising Pharmacy Costs, External Market Disruption, Operational Effectiveness, Opioid Management

RELATED: How Healthcare Leaders Leverage the 2019 HCEG Top 10 List

Networking Events at 2019 HealthCare Executive Group Annual Forum

Beyond the content presented at HCEG’s Annual Forum, our event aims to support new introductions and grow existing relationships between healthcare executives. Keynotes from industry leaders help set the context. Then informative sessions help flesh out – and flush out – the challenges, issues, and opportunities, facing healthcare executives. Some fun and structured opportunity to interact can go a long way.

And participants of the HealthCare Executive Group’s 2019 Annual Forum will enjoy two events providing support for meeting new people, sharing your knowledge, expanding your network, and perhaps rekindling stale relationships. Indeed you’ll meet new people, learn a lot, eat well, and experience new entertainment.

Red Sox vs. Yankees Baseball Game at Fenway Park

Forum attendees are invited to a private reception on the Coca-Cola Field Deck at Fenway Park – widely known as some of the Best Seats for Partying and Socializing at Fenway Park.  Immediately following this private networking reception, all Annual Forum attendees will enjoy the Red Sox vs. Yankees Game.

Note: This special networking event is located directly across the street from the annual forum venue and is included with 2019 Annual Forum registration at no additional cost on a first-come, first-served basis.

IBM Watson Experience Center

Another unique event at this year’s annual forum is small group tours of the IBM Watson Experience Center. The tour includes an open discussion of technology applications in healthcare. Transportation to and from the forum venue and the IBM Watson Experience Center will be provided.

RELATED: See pictures, program guide and more from last year’s 2018 Annual Forum 

Exceptional Meals, Venue, C-Suite Participants, & Networking Opportunities

The HealthCare Executive Group’s Annual Forum is unlike any other healthcare conference event. In fact, our annual forum is pretty much the opposite of other healthcare events:

Intimate and Accessible vs. Impersonal and CrowdedHealthCare Executive Group HCEG Annual Forum

The venue, sessions, and seating are all designed for maximum attendee comfort and interaction.  Moreover, HCEG’s annual forum includes unique networking events so forum participants can expand their network and create meaningful relationships.

Participating in our Annual Forum can truly advance attendees professional and personal goals.

Healthcare Industry Leaders Addressing Today’s Challenges vs. Coin-Operated Speakers

Speakers at our annual forum are well-established, well-known healthcare industry leaders. They won’t be selling anything except great insight on the challenges, issues, and opportunities facing today’s healthcare leadership. In today’s uncertain and increasingly volatile healthcare industry it’s critical to get unbiased insight.

Some of the Speakers at HealthCare Executive Group’s 2018 and 2017 Annual Forums:

      • David Shulkin, former Secretary of the Veterans Administration and Chief Innovation Officer of Sanford Health
      • Karen DeSalvo, Assistant Secretary for Health at U.S. Department of Health and Human Services
      • Andy Slavitt, former Acting CMS Administrator and current leader of Townhall Ventures
      • Craig E. Samitt, MD, MBA, President & CEO of BCBS of Minnesota
      • Brandon Cady, President & CEO of Anthem/AIM Specialty Health
      • Kyle Rolfing, Co-Founder & President of Bright Health
      • Tony Miller, Co-Founder & CEO of Bind on Demand Health
      • Donato Tramuto, CEO at Tivity Health
      • Dan Buettner, National Geographic Fellow, NY Times Best Selling Author

Healthcare Executives & Leaders vs. Every Other Role Under the Sun

Participation in HCEG’s Annual Forum is limited to healthcare executives and leadership serving health plans, health systems, and provider organizations. The majority of attendees reside in the C-suite and all registrations are screened. Media, unscreened vendors of any sort, and ‘all-comers’ willing to pay the small registration fee are not allowed.

No 3rd Party Pitches vs. Vendor Salespeople and Booth Barkers

You won’t find any vendor exhibits at HCEG’s Annual Forum. And HCEG sponsor partners participate in the forum in a passive, consultative fashion. No sales pitches or vendor marketing materials are allowed.

Relaxing Venue with Great Food & Drink vs. Box Lunches and Waiting in Line for Coffee

Great content and insightful speakers alone do not make a conference worthwhile. Accordingly, HCEG places a lot of thought and effort into selecting an accessible venue. Our annual forum offers a comfortable environment supporting the exchange of information and ideas. Excellent food, drink, and refreshment is always available to forum participants.

Join Other Healthcare Leaders in Boston on September 9th

Come join other healthcare executives and industry leaders in Boston on September 9th-11th and be a part of a manageable, information-packed event. In addition to the keynotes, sessions, Top 10 ranking, and special networking events noted above, we’ve got some additional sessions and uncommon healthcare conference surprises in store.  Contact Juliana Ruiz if you require any assistance.

Healthcare Executives Address Industry Challenges, Issues, & Opportunities2019 Annual Forum of the HealthCare Executive Group (HCEG). Ideas, 'Best Practices' and lessons learned. Intimate venue insight, ideas, and actionable information. 2020 HCEG Top 10 list.

RELATED: Announcing Individual Membership in HealthCare Executive Group

HCEG Webinar Series. Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization. The Golden Triangle. Operational efficiency. 2019 HCEG Top 10 list. HealthEdge. business transformation initiatives. Sal Gentile, Friday Health Plans.

The Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization

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People, process, and technology are at the core of every business. And how these three critical components are used to create and deliver a healthcare organization’s products and services ultimately result in company profitability and growth. Indeed, the critical challenges healthcare organizations are facing during these uncertain times involve humans, the processes they must follow, and the mix of entrenched, emerging – and as yet- often unknown technologies supporting an organizations mission and growth.

Transforming your healthcare organization requires an explicit focus on effectively aligning the Golden Triangle of People, Process, & Technology.

The Golden Triangle: People, Process, & Technology

HCEG Webinar Series. Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization. The Golden Triangle. Operational efficiency. 2019 HCEG Top 10 list. HealthEdge. business transformation initiatives. Sal Gentile, Friday Health Plans.

Delivering operational efficiency, a key aspect of transforming today’s healthcare organizations requires an approach that optimizes the relationships between people, process & technology; hence the Golden Triangle. Each part of the Golden Triangle is its own science. And each needs to be mastered to effect true transformation and business growth. Ignore the relationship between people, process, and technology at your own risk.

And know that the art, where real value and efficiency are found, is at the intersection of people, process & technology. Like a three-legged stool, each part of the Golden Triangle must be sufficiently developed and aligned as integral components of successful transformation initiatives. Too often, healthcare organizations give short shrift to the people point of the triangle.

RELATED: Operational Efficiency Ranked #7 on 2019 HCEG Top 10 List

Successful Transformation Initiatives: Keys to Success & Challenges

In a study by IBM titled “Making change work…while the work keeps changing,” 1400 participants identified the keys to successful change initiatives and the major challenges to change that organizations must consider as they plan and strategize their business transformation initiatives.

Keys to Successful Change Initiatives at Healthcare Organizations

People Factors

    • Employee Involvement
    • Honest and Timely Communication
    • Change Agents to Engage Other Employees
    • Change Supported by Culture
    • Efficient Training Programs
    • Monetary and Non-Monetary Incentives

Process Factors

    • Adjustment of Performance Measures
    • An Efficient Organizational Structure
    • Top Management Sponsorship

Challenges to Change Initiatives at Healthcare Organizations

People Factors

    • Changing Mindsets and Attitudes
    • Corporate Culture
    • Shortage of Resources
    • Lack of Commitment by higher management
    • Insufficient Change Know-How
    • Little to no Transparency

Technology Factors

    • Impact on Existing Process
    • User Experience
    • Flexibility and Interoperability of Technology Systems

See this article for more about the keys to successful change initiatives and the major challenges to change that organizations must consider as they transform their organization.

People are Key to Aligning People, Process, & Technology

Famed IBM founder Thomas J Watson shared the following on the importance of NOT ignoring the people component of organizational change initiatives.

“Teach your associates to teach themselves and in a way that you will strengthen the entire organization” – Thomas J Watson (1947)

Additional Insight & Ideas on Leveraging People, Process, & Technology

In today’s uncertain and rapidly changing healthcare environment, healthcare leaders are seeking to enter new geographies, start new lines of business, or even radically transform their traditional way of doing business. To position your healthcare organization for successful growth by optimizing the intersection of people, process, and technology, join us on July 25th for our Webinar Series event: Using People, Process & Technology to Grow Your Business.

Sal Gentile, CEO of Friday Health Plans and our sponsor partner HealthEdge will share how they leveraged the art and science of people, process and technology to successfully grow their respective healthcare organizations both from the ground up as well as within an established organization.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

If you’re not sure whether you can attend this HCEG Webinar Series event, go ahead and register and we’ll send you the recording/recap.

If you have any questions about this blog post or want to learn more about the HealthCare Executive Group, please reach out to us at [email protected]. Also, consider following @HCExecGroup on Twitter and LinkedIn.

2019 AHIP Institute & Expo. HCEG. Healthcare Executive Group. Nashville, TN. David Cordani, Cigna Healthcare. Health Care Cost Institute (HCCI) Niall Brennan. CMS. National All Payer Claims Database (APCD) Public Data, Interactive Tools Related to Health Care Cost Utilization

Insight & Observations from the 2019 AHIP Institute & Expo

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The 2019 AHIP Institute & Expo took place in Nashville, TN earlier this month and our Executive Director Ferris Taylor was in attendance – along with many of our members and sponsor partners. This post shares just a bit of what Ferris observed. Also included are some recaps of the event shared by industry media and analysts.

Cigna CEO on Importance of Access, Affordability, and Eliminating Surprises

Wednesday’s afternoon keynote, A Blueprint for a More Sustainable Health Care System, was presented by David Cordani, President & CEO of Cigna Corporation. David’s introductory message emphasized the importance of access, affordability, and eliminating surprises. During his 45-minute session, David shared the following thoughts and ideas – among others:

Healthcare organizations – and the companies that support healthcare organizations – need to understand the needs of the people and companies they want to do business with and then earn the “right” to meet those needs.

In the quest for the digital transformation of their healthcare organizations, healthcare leaders should consider and address the “transactional going to transitional going to transformational”

Treat the whole person and be sure to do your best to connect individuals (plan members and patients) with providers. Drive this change through innovation

Some statistics shared by David Cordani

  • The United States is the only place in the world you want to be if you have a critical medical conditional.
  • In 1992, the healthcare industry resisted
  • In 2008, the healthcare industry collaborated
  • In 2020, will the healthcare industry choose to lead?

What is the Health Care Cost Institute (HCCI) and Why Should You Care?

2019 AHIP Institute & Expo. HCEG. Healthcare Executive Group. Nashville, TN. David Cordani, Cigna Healthcare. Health Care Cost Institute (HCCI) Niall Brennan. CMS. National All Payer Claims Database (APCD) Public Data, Interactive Tools Related to Health Care Cost Utilization

Ferris Taylor (left) & Niall Brennan

Niall Brennan, former Chief Data Officer at CMS and current president & CEO of HCCI, joined Melinda Buntin, PhD, Chair of the Department of Health Policy at Vanderbilt and Robert Town, PhD, HCCI board chair and professor of economics at University of Texas-Austin to share an overview of the Health Care Cost Institute.

For those who may not know, the Health Care Cost Institute (HCCI) is the first qualified entity recognized by CMS for quality, efficiency, and use of resources. The speakers shared an overview of the benefits of collaborating and sharing data with HCCI and how HCCI members have access to the following types of Healthcare Market Intelligence:

  • benchmarking enrollment, utilization, and payments
  • provider profiling (understanding and tiering networks)
  • care management (patient identified data)
  • custom analysis (utilization of care, alternative payment methods, Rx, etc.)
Niall Brennan will be presenting the breakfast keynote at HCEG’s 2019 Annual Forum on Tuesday, September 10, 2019. For more information about our Annual Forum, click here.

Niall also shared some information on the National All Payer Claims Database (APCD) and emphasized that without data, states without APCD’s are flying blind with little or no ability to assess cost or quality. The group urged all attendees with the power to do so, to submit their data to HCCI and then focus on using the information and data HCCI generates in return to for quality and improvement programs.

Additionally, a general consensus among the speakers was their surprise that employers are not outraged over the variation in healthcare prices and even more with the fact that, while demand for some services is declining, in many cases prices are still going up.

For more information about HCCI including how to become a partner, click here.

RELATED: HCCI Research, Public Data, and Interactive Tools Related to Health Care Cost and Utilization

AHIP President & CEO Matt Eyles – Speaker at HCEG’s 2019 Annual Forum

At the AHIP event, Matt Eyles, AHIP’s CEO & President, shared his take on “What the Industry needs to do to address Health Care’s Challenges.” Matt will also be speaking at HCEG’s 2019 Annual Forum on Tuesday, September 10, 2019. For more information about our Annual Forum, click here.

Social Determinants of Health at AHIP Institute & Expo

Unsurprisingly, social determinants of health – ranked #3 on the 2019 HCEG Top 10 list – was a popular topic at the AHIP Institute & Expo. Check out these articles and resources on this hot topic impacting health plans, health systems, and provider organizations.SDOH. Social Determinants of Health. Total Population Health. HCEGTop10. HCEG. Healthcare Executive Group. Population Health Services: Operationalizing community-based health strategy, chronic care management, driving clinical integration, and addressing barriers to health such as social determinants.

AHIP Launches Project Link to Address Social Determinants

AHIP Institute Takeaways

At AHIP 2019, Health Plan Leaders Parse the Challenges and Opportunities of SDOH

Insurers to work together on social barriers to health

At the AHIP 2019 Conference, Former Surgeon General Murthy Speaks of Social Isolation and Its Impact

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“Healthcare Organizations Focus on Data & Analytics for Digital Transformation”

“Release of the 9th Annual Industry Pulse Survey Results”

Artificial Intelligence. Predictive Analytics. Bigdata. Machine Learning. HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.

Insight on Solving the Rubik’s Cube of Payer Data

By | analytics, HCEG Top 10, payer, Sponsor, Webinar Series | No Comments

Healthcare payers are sitting on a lot of data, from eligibility data, to claims data, to data obtained from 3rd parties, to data derived from analytics. It’s no surprise that over the last decade “Data & Analytics” has been a consistent entry on the HealthCare Executive Group’s Top 10 list of challenges, issues, and opportunities facing healthcare executives. And currently ranked #1 on the 2019 HCEG Top 10 list. To help share insight, ideas, and actionable information supporting data and analytics, our sponsor partner EQ Health Solutions presented our June Webinar Series event: Solving the Rubik’s Cube of Payer Data.

Chief Strategy & Growth Officer Mayur Yermaneni and Marina Brown, RN BSN, Vice President of Clinical Programs, from eQHealth Solutions shared information and insight on the following four topics:

  • The current state of the payer market and future considerations
  • The Rubik’s Cube of Payer Data – the Present Debacle
  • What tools and technologies will lead to continued payer success?
  • Top six things to consider when evaluating your healthcare analytics vendor

Highlights from Solving the Rubik’s Cube of Payer Data

This blog post presents some highlights from the webinar and provides access to additional information from the webinar. You can also check out this Twitter Moment summarizing live Tweets from the webinar.  The complete recording of the webinar can be found here. To jump to the specific place in the recording, click on the timestamp range [HH:MM] that accompanies each transcripted section below.

HealthCare Executive Group Top 10 list. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.

For more information on how EQ Health Solutions can advance your organization’s data and analytics initiatives and programs, contact EQ Health Solutions.

Current State of the Payer Market and Future Considerations

Mayur Yermaneni shared some insight into current data and analytics capabilities of healthcare payers: [7:16]

Some payers are firmly in an average spectrum of recognizing current trends and some and some payers are still in the infancy stages of recognizing the impact of these trends. So, I’m trying to generalize some of these themes so that everybody can actually benefit from it.

Margins are Decreasing

So, across the board, one of the key things, and I guess this is not unique to the payer market itself, is that margins are decreasing. With new regulations coming on board there are more and more cost burden associated with the payer market. Some payers are becoming a financial institution from that standpoint [of increasing regulatory burden.]

Mega Mergers

You see this a lot more in the bigger payer, payers like Aetna’s acquisitions, United’s acquisitions, WellCare and all these acquisitions that are happening is [intended] to counter their decrease in margins by creating economies of scale that they could benefit by actually saying: “If I can actually acquire another of these entities, then I can create a cross burden rate across these common units and hopefully benefit from the margins play game.”

Data Security

Nobody wants to show up and in tomorrow’s Wall Street Journal. In the current day and age, there’s an entire team dedicated just so that that payer’s name doesn’t show up on tomorrow’s newspaper. Primarily because with the PHI (Protected Health Information), the abundance of PHI information from all different sources. It’s extremely important to say: “Well how do we protect our data?” Payers have a lot more data than anybody else outside of providers.

And there are two different spectrums of the data set – and both are equally critical from the standpoint of ensuring that data security is a key aspect in your space because today, a 100 record, 500 records, or anything above that threshold you’re going to have to report it. So, data security becomes actual strategy nowadays. How do you make sure that your data security is actually playing to your advantage? And your customers have to be able to trust that and that Trust is what’s going to actually give you – even though that has nothing to do with the actual health plan itself, or the benefits members are receiving, or the card that they are receiving. But they still have to be able to trust that their data is secure. 

Showing Value Vital in Provider/Hospital Negotiations [10:17]

Finally, when it comes to providing the value of data, the data set that payers are actually having to wrestle with: how are we showing the value that we are providing to the hospital segment, the provider segment, and the member segment? 

But if you look at it, you still have to deal with all the other aspects before you get to the value component: administrative setup, data security, operating margins, and everything.Contract negotiations. HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.Well, how is that actually happening? Big data. Well, I’m not going to bore everybody with the definition of what big data is but, in a nutshell, in today’s world of Instagram, Facebook and Snapchat it’s all about the volume and speed and the frequency of the data that you’re receiving. And in the payer market, it’s a lot of data. It used to be a monthly fee [to obtain/access data]. Now it’s an API call to an HL7 message which is instantaneous. And the amount of frequency that you’re having to deal with is a lot more than what you had before. And the number of types of data that the payer market is actually having to deal with is a lot more. And even in there, the data can be segregated into a couple of different ways: 

  • The data that’s the primary data sources
  • The derived data sources that you’re generating as a result of your operation or as a result of some of the analysis that you’re doing on top of it. 

So now that’s another big trend that the payer market is having to actually wrestle with.

Social Determinants of Health Data are Increasingly Important

Ferris Taylor [HCEG’s Executive Director] indicated that this [Data & Analytics] was the top topic and social determinants of health were one of the key aspects to it. And that hasn’t changed. What has changed is how that’s being viewed. Instead of being a peripheral data source to actually being a central component to how your operations need to be done from social terms of health standpoint.

Marina Brown, EQHealth’s Vice President of Clinical Programs added:

I was just going to say that I do think that this is really a big one for the industry. Social determinants of health are definitely going to help change the way that we deliver health care. And that’s a very important distinguishment. It’s not going to change the way that we do health care because we treat a diabetic the same but it will change the way that we deliver care simply by helping to better guide the interventions that we’re utilizing to create more meaningful behavior change over time.

Tools and Technologies to Solve the Rubik’s Cube of Payer Data

Marina and Mayur shared an overview of the tools and technologies that healthcare payers are using to identify trends, root causes of patient and population-level issues, and transforming healthcare payer’s data and analytics infrastructure.

Another key aspect is artificial intelligence. Now again I don’t want to get into the definitions of artificial intelligence, but the key aspect is, with the advent of big data with the advent of the amount of data you’re having to deal with. It’s not humanly possible for a supervisor or a manager or a management team to be able to simulate all the data and actually say: What am I making use of this data? And how am I going to make use of this data? And what decisions am I making?

So artificial intelligence – or machine learning – and they’re not necessarily synonymous but in some in some aspect they’re synonymous in terms of combining the wealth of data that you’re getting and actually seeing what insights can be derived based on all those data sets; at a much more faster pace and a more timely manner compared to what we would have had to do if we were doing it manually. And there is an element of: how do we use the machine learning algorithms or artificial intelligence approaches to say: Can I do a better prognosis?

Everybody’s aware of [IBM] Watson’s cancer cure approaches to it and Watson has evolved a lot of other stuff. But predominantly in the mainstream the payer market, this hasn’t yet taken off into a full-fledged problem because we’re dealing with not necessarily a literature research but more in the realm of operational research and operational analytics.

Hear more from Mayur and Marina about tools and technologies at [13:09] and [24:53] in the recording.Artificial Intelligence. Predictive Analytics. Bigdata. Machine Learning. HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data.

How can we employ artificial intelligence or machine learning concepts into the operational realm of the payer operation? [14:40]

There are some positive trends. There’s a huge growth of Medicare Advantage (MA) plans. Their margins continue to increase because it’s a catch-22 situation for MA plans because of the risks. And now MA plans are able to accurately reflect their risk scores. And as a result, their premiums are being reflected the right way – which actually helped them from their margin standpoint because their operations were still on the same aspects of it because in the previous era they were not reporting their risk the right way because they didn’t have all the data gathering up opportunities. But now that they’re able to gather their [data analysis] opportunities, they can predict their risk a lot more accurately, so their premiums are going up. As a result, the margins are getting better and also the operations have stayed the same.

Government Plans Off-Loading Operational Functions to Health Plans

And in the Medicaid managed care space what you’re seeing is a lot more growth in that space for, predominantly, what we could say s for one single reason: most of the state administrative entities are actually trying to off-load the burden onto the plans so that risk is being passed on to the managed care plans and the state entities become the administrative agency. Of course, with that, they’re also holding performance measures as an accountability which is not just about the financial side of it but also the quality side of it because they don’t want to sacrifice the quality of care being rendered to their beneficiaries. But as a result, you’re seeing a lot of growth in the managed care space Medicaid managed care well

What does this mean to me or my organization as a payer? [16:29]

If I actually eliminate all the big terminology, fundamentally there are two simple concepts:

  1. Is our plan performing better than what it was before from a cost standpoint? And with the qualifier added, is the plan performing to a level where the plan can afford too? Because one of which you’re collecting to your risk is what you’re paying out. That’s one of the key foundations. That’s a simple question that you’re going to answer.

And the second aspect of it is:

  1. Are we improving the quality of our plan? And quality can be defined in multiple ways. I think the STAR rating, the HEDIS measures, and all that stuff. But at the end of the day it’s really are you improving quality in terms of outcomes for the members?

And the second point is actually impacting the first point from a long-term standpoint. So, if you’re impacting the quality aspects of it, then you’re able to impact the cost aspect of it as well. But it doesn’t happen every year, it happens over as a strategic view. You have to put that as a strategic view long term view so that on the short run your cost structure might have variances but over a long run, you’re actually improving the trends of that one.Rubik’s Cube of Payer Data. Artificial Intelligence. Predictive Analytics. Bigdata. Machine Learning. HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.

Operational Simplicity and the Health of Your Health Plan [17:54]

But what does that mean in terms of a payer when you think about how you have to think about it?

It comes down to two things: operational efficiency and health of your health plan. How do we make a difference in looking at all the data that we have and actually answer these two business questions; and then tie them back to the simple questions of ‘Am I performing better in terms of cost?’ And ‘Am I improving the cost?’

Marina added: [18:38]

I think that operationally looking at the data is really going to, as a program administrator, is going to give me insight into things like the following:

  • What care management programs or medical management programs are most needed for my population?
  • What programs that I’m currently utilizing are really the most effective ones?

Taking that a step farther as you look into those specific programs that are most effective, you’ll also then be able to look at things like: What are the interventions that are most effective in this population. From a utilization review perspective?

Is my UR working only as a gatekeeper for my health plan or are we actually effectively managing acute episodes and beyond that acute episodes? And then really helping us determine all of this ultimately helps us determine what care intervention strategies do we need to tweak? Which ones do we need to add to our programs to create that meaningful behavior change that increases the health of our membership, increases the quality of the care that’s being provided to that membership, and ultimately reduces the cost?

The Rubik’s Cube of Payer Data – the Present Debacle

Mayur shared some insight into the struggle that many payers have regarding reporting and analytics: [20:03]

In a lot of ways, payers are struggling between: Am I doing reporting or am I doing an analysis? And how am I looking at it? Am I doing the analysis for the sake of reporting or am I doing analysis for the sake of improving or answering the two questions that we started out with?

  1. Is our plan performing better than what it was before from a cost standpoint?
  2. Are we improving the quality of our plan?

HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.And those could be the patient member outcomes, quality standards, STAR ratings, keeping benefits cost down, maintaining the profit margin, improving efficiencies. All of these are questions that every payer is asking.

And the list goes on and on and you guys are actually dealing with a lot more in today’s world. I’m sure every organization has a ton more questions to add to it but, fundamentally, why and how to do it is where the biggest question comes into play because often everybody goes down the path of: ‘Okay, I need to solve this reporting problem so I need to have this kind of technology in place. I need to solve my data analysis problem from a predictive modeling standpoint, so I need to have this technology base.

And as a result, you’re creating more and more silos within the analytic space and not necessarily taking advantage of the full spectrum of the data that you have or creating in its entirety in a holistic view. Because at the end of the day, if the technology analytics is being used for the reporting purposes then you only solve 30% of your problems because the majority of your problems are deriving insights from your data and actually saying how can we make a difference in our operations? How can we make a difference in our outcomes?

Payers have multiple data sources and everything is often viewed as a silo. [23:30]

Healthcare organizations are maturing but fundamentally they’re still struggling with the aspects of:

  • Am I doing quality analysis?
  • Am I doing financial analysis?
  • Am I doing operational analysis?
  • Or am I doing just reporting for the regulatory agencies?

Payers need to design their operational strategy to leverage all quadrants of dimensions: Quality, Financials, Operations, and Predictive Analytics.

Marrying Clinical Expertise with Data Analytic Capabilities [25:04]

HealthCare Executive Group Top 10 list. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.

I want to talk briefly about the key components that are going to make a difference. Often what happens is an analyst is asked a question and they actually come back and that data set is then presented to clinical leadership. And then clinical leadership asks a follow-up question and then makes some decisions on top of it. But in reality, what if you change that and involve that clinician up front during the analysis itself, along with the data scientist? So, what we view in the industry is that there’s a lot more benefit if you actually pair the clinicians and the data scientists together up front in the design and analysis phase.

So that 1) you can cut down your cycle crime and 2) you’re asking the questions up front and how to think about your operations. And that’s going to help frame your reporting and analytics problem in a way where you’re getting to a solution much faster.

Marina added:

I think that’s a really important point that you’re making. I think bringing these two teams of people together helps to bring about that important balance and maximize your outputs because your data scientists are experts at identifying the trends and the data. And when that information is presented to the clinicians, they can then help interpret those trends. That’s going to ultimately formulate your adjustments to your operations, your program design, etc. I think that’s a great point.

Pairing Clinicians with Data Scientists Frees Up Time for Patient Engagement

Mayur continued:

And another aspect to it is, when you’re thinking for clinicians, you’re actually taking away their valuable time working with a member. If you’re asking them to understand what’s happening with the data and go into the exercise and then making the decision to it. But if you pair them up front, you’ve solved the problem and then you’re giving them time to have their team’s focus more on the members then they are focusing on the data itself.

Marina added:

Right. Care teams are so busy trying to make that outreach to the members that having that technology available to them, to be able to guide them to identify trends or issues with that particular member, is going to save time. And it ensures too that all of the important or pertinent trends for that particular member, for that particular population, are being identified. Because at the end of the day, clinicians are just that, clinicians. They’re not data analysts.

Developing a Multi-Dimensional, 360-Degree View of Your Data

Marina and Mayur presented some insight and ideas on how to create a decision-making framework providing a multi-dimensional, 360-degree view for your clinical, operational, administrative, and financial teams.

See [28:15] for more information, insight, and ideas on creating a multi-dimensional, 360-degree view of your clinical, operational, administrative, and financial data.

Top Six Things to Consider When Evaluating Healthcare Analytics Vendors

Here are top six things that you should consider when you think about analytics or in the majority of organization’s how you want to get there.

  1. Data Security
  2. In-House Experts
  3. Intuitive Easy-To-Use Platform
  4. Actionable Real-Time Data Visualization
  5. Data Accuracy
  6. Acceptance of Data in Any Format

For details on the importance of each of the above considerations for evaluating healthcare analytics vendors, listen in starting at [36:04].

Questions from Webinar Series Attendees

Our organization currently executes minimal analytical formalities, processes, etc and we are at an immature analytical state. Would investing and working with an analytics vendor refute all [our efforts] at this stage in our organization? [44:37]

Mayur: No. You can view it from the standpoint of: if you’re in the early stages of maturity then that would be the perfect time to assess how you want to design your system and what kind of systems you want to have in place. And you may not have to go through the same evolution steps that the entities started out early on. You may actually leapfrog by taking in all that stuff up front itself. So absolutely, even if you don’t have all the data organized in a unified view that’s fine too because you do have data sets. The first steps very well could be how do you get them into the unified view. So I wouldn’t hesitate working with and investing in analytics if you’re in the early stages of maturity because this very well could be an opportunity where you don’t have to redo the some of the things that you might have done if you’re already in further stages.Artificial Intelligence. Predictive Analytics. Bigdata. Machine Learning. HealthCare Executive Group. Benefits Costs. Patient Outcomes. Quality Standards. STAR ratings. Profit Margins. Improving Efficiencies. EQ Health Solutions. Solving the Rubik’s Cube of Payer Data. Health Plans. Payer market. evaluating healthcare analytics vendor. Data Security. Tools and Technologies.

Our organization prides itself on taking the best care of our patients. Can you give us examples of how using an analytics vendor can improve our patient outcomes vs. just us monitoring it internally? [46:03]

Marina responded to this question with an interesting story about how EQ health identified and assisted high-utilization, low literacy, diabetic patients in the Mississippi Delta.  Listen at [46:22] as to how EQHealth made life easier for patients and improved their health, all while reducing emergency room visits and inpatient admissions.

My team is discussing the decision to build an analytics platform internally or buy and outsource it with a vendor. Do you have any insight into what is more successful and pros and cons? [50:50]

Mayur: I don’t think there is a right answer or wrong answer. It really centers on your strategy. Are you trying to make that as your core competency or are you wanting to retain your core competency to manage plan operations but want to have the benefit of the analytics and the analytics platform; then at that point you should outsource. But if you’re wanting to make analytics your core competency, then you need to have that in-house. But when you do decide to make it in-house, you still need to… hear the rest of Mayur’s answer at [51:08]

Listen to more questions and answers from Solving the Rubik’s Cube of Payer Data here.

More Insight for Healthcare Leaders

Our Webinar Series events are one example of how the HealthCare Executive Group helps to share information and promote collaboration between our members, associates and sponsor partners. Our next Webinar Series event will be ‘Using People, Process & Technology to Grow Your Business’ and will be presented by our sponsor partner HealthEdge on July 25th, 2019 at 2:00 pm ET.HCEG. HealthCare Executive Group Webinar Series: ‘Using People, Process & Technology to Grow Your Business’ HealthEdge.

HCEG’s 2019 Annual Forum

Save The Date HCEG Annual Forum

In addition to connecting with us on Twitter and LinkedIn and subscribing to our eNewsletter, consider joining other healthcare executives and industry thought leaders at our 2019 Annual Forum in Boston, MA on September 9-11, 2019. In addition to the always insightful, information-packed sessions and networking opportunities our annual forum offers, we’re including two special networking events on Monday, September 9th:

  • Tour of the IBM Watson Research Facility in the morning
  • Red Sox vs. Yankees Baseball Game at Fenway Park in the evening

For more information, click here and/or contact us at [email protected].

HCEG Webinar Series Event. “Solving the Rubik’s Cube of Payer Data” Digital transformation. HCEG’s Top 10 Data & Healthcare Analytics. Artificial Intelligence, Machine Learning. Electronic Health Records. EHR. Claims Data. EqHealth Solutions. CMS’s Meaningful Use program. Industry Pulse Social Determinants of Health. Value-based Care. Alternative Payment Models

Healthcare Organizations Focus on Data & Analytics for Digital Transformation

By | analytics, Sponsor, Value-Based Payment, Webinar Series | No Comments

If analytics is the machine powering your digital transformation initiatives, then data is the power making that digital transformation machine run. The importance of data and analytics has been identified by our members in each of the last ten years HCEG’s Top 10 list of challenges, issues, and opportunities have been created. For 2019, “Data & Analytics” is ranked #1 on the HCEG Top 10. It’s clear that healthcare leaders believe that data is a catalyst to accelerate meaningful change. And that the use of analytics – particularly prescriptive analytics – is a fundamental strategy for succeeding in a new era of healthcare.

Mountains of Data Waiting to Power Your Healthcare Analytics Machine

Good analytics begins with good data and healthcare organizations are sitting on a mountain of data. According to America’s Health Insurance Plans (AHIP), the typical regional payer processes $8 billion in claims each year with each claim providing its own set of unique data points – largely financial and administrative. But healthcare payers are increasingly collecting, matching, and using clinical data to provide richer, more comprehensive insight on their members.

Given the proliferation of Electronic Health Records (EHR) incented by CMS’s Meaningful Use program, it’s no surprise that more and more data is being pulled from EHR’s. And risk-sharing agreements between payers and providers has resulted in health plans sharing more claims data with their provider partners. In fact, the current Industry Pulse report indicates that EHR data is one of the top two primary sources of clinical data with 30% of health plans reporting they utilize EHR data.

digital transformation. HCEG’s Top 10 Data & Analytics. Artificial Intelligence, Machine Learning. Electronic Health Records. EHR. Claims Data. EqHealth Solutions. CMS’s Meaningful Use program. Industry Pulse Social Determinants of Health. Value-based Care. Alternative Payment ModelsOther sources of clinical data that organizations are using to complement their claims data include ancillary data such as pharmacy, lab, and imaging (17%) and real-time admission, discharge, and transfer notifications (10%)

RELATED: 9th Annual Industry Pulse Research Survey Results

Popular Use Cases for Healthcare Analytics

These enhanced data sources are becoming more and more useful due to the power of artificial intelligence (AI) and machine learning.

New research from Dimensional Insight identifies care quality measures and finance as two top use cases for healthcare organization usage of analytics today. Additional use cases for leveraging data by analytics include

  • Addressing Social Determinants of Health (#3 on the 2019 HCEG Top 10)
  • Value-based Care and Alternative Payment Models (#4 on the 2019 HCEG Top 10)
  • Improving Patient Engagement and Satisfaction
  • Patient Outcomes Improvement

Analytics Budgets are Increasing for Healthcare Organizations

According to a recent report from the Society of Actuaries, greater than 60 percent of payers and providers are planning to increase their analytics budgets by 15% or more.

Additionally, the report finds that 89% of healthcare executives plan to use predictive analytics over the next five years. It’s clear that healthcare payers and health systems have a keen focus on leveraging the massive amounts of data they possess. These data serve to reveal trends, patterns, and insights to help ensure their success going forward.

Solving the Rubik’s Cube of Payer Data

i.e. Lining Up All Your Data to Rapidly and Accurately Gain Unique Insights

For insight into how your healthcare organization’s data can be used to improve health outcomes and reduce costs, join our next Webinar Series Event on June 6th at 2:00 PM EDT / 11:00 AM PDT. Our sponsor partner eQHealth Solutions presents “Solving the Rubik’s Cube of Payer Data.”In this complimentary webinar, you will learn how to aggregate and parse provider data, how you can use data captured outside of your own system, and other practical solutions to use your data to create knowledge for actionable use and outcomes. Attendees will have a chance to ask questions and all registrants will receive a copy of the presentation afterward.HCEG Webinar Series Event. “Solving the Rubik’s Cube of Payer Data” Digital transformation. HCEG’s Top 10 Data & Healthcare Analytics. Artificial Intelligence, Machine Learning. Electronic Health Records. EHR. Claims Data. EqHealth Solutions. CMS’s Meaningful Use program. Industry Pulse Social Determinants of Health. Value-based Care. Alternative Payment Models

How Healthcare Executives Leverage HealthCare Executive Groups Top 10 List. HCEG Top 10. Digital transformation. WHCC. World Health Care Congress.

How Healthcare Leaders Leverage the 2019 HCEG Top 10 List

By | HCEG Top 10, Social Determinants of Health, WHCC | No Comments

How has the HealthCare Executive Group’s annual Top 10 list of challenges, issues, and opportunities helped to guide healthcare leaders and their companies over the last decade?

During a break at the 16th Annual World Healthcare Congress held in Washington, DC earlier this month, our Executive Director Ferris Taylor had a chance to talk with Mabel Jong of MJC Communications, LLC. Ferris recounted the story of how members of the HealthCare Executive Group have developed and used our annual ‘Top 10’ list of challenges, issues, and opportunities as a means of to verify, validate, and address their top challenges, issues, and opportunities.

The following is a verbatim transcript of that interview – with a few links and supporting information added in for clarity. You can watch the actual recording here and sign up to receive our eNewsletter here.

Talking About the 2019 HCEG Top 10 List at World Health Care Congress

Mabel Jong: And welcome back. I’m Mabel Jong and you’re watching live coverage of the World Health Care Congress on WHCCTV. Thank you so much for joining us.

We’re going to learn a little bit about the HealthCare Executive Group. Their executive director Ferris Taylor is here.

Ferris Taylor: Well thank you Mabel, it’s good to be with you.

I understand you’re from Boston where the HealthCare Executive Group started in 1988 in Maynard, Massachusetts when a mini computer manufacturer disbanded their healthcare user’s group. That group of users said: “Forget about Digital Equipment, we find value in networking, being able to share the challenges and the opportunities of healthcare” To have somebody around the country that I can pick up the phone and call and say: “Hey, I’m having this problem.

And if my colleague in Minneapolis says: “I’m not having that problem,” then maybe there’s something wrong with me. Or maybe, we have something to talk about. Or if we both have that problem, then how are we solving that?

So, it’s a small network 100 members or so, primarily technology leaders in their organizations, payers, and providers that find personal, professional and organizational value in sharing ideas about how to address the challenges in healthcare. And as you know, we have lots of lots of them.

Mabel: Lots of them. And in terms of sharing ideas, you also have done a lot of research on coming up with a top 10 list. Not David Letterman’s top 10 list but…

Ferris: It started out that way.

Mabel: Okay. Share with me what this list is about and who makes it.

RELATED: Recapping 16th Annual World Health Care Congress & CIO/CTO Strategy Track

Healthcare Leaders Identify Issues, Challenges, & Opportunities

Ferris: And it’s fascinating because from the very beginning there was always a conversation about the challenges in healthcare. And 10 or 15 years ago the CIO at Health Partners,

Alan Abramson said: “You know, when I go home from our meetings, my executives asked me what we’d been talking about and I tell them.”

But there would be value if we actually went through a process and shared with the industry what our members see as the challenges in the foreseeable future in health care.

So about 15 years ago we started publishing, and at the time it really was (based on) the David Letterman (Top 10 list). We keyed on that – ‘here’s our top ten list.’ And it’s evolved from that. Our members at the end of the year actually vote from a list of 30 or 40 issues that we talked about in the year – what their top 10 issues are. And then we go through a process of ranking them and it (HCEG’s Top 10 list) becomes the benchmark that our members use.

And I recommend that other companies, other healthcare stakeholders around the industry use the Top 10 list to ask themselves: “Am I addressing these issues? Are they on my priority list? What’s my action plan with respect to those issues?”

Mabel: Okay. So, does it go from most important to…

Ferris: We do rank them.

Mabel: Okay. So, number one, you have Data and Analytics all the way to number 10 cybersecurity.

Ferris: That’s a big range.

Mabel: That is a big range. So, people are saying these are the issues that we’re currently facing and that we’re concerned about.

Something Old, And Something New on the 2019 HCEG Top 10 List

Ferris: Exactly. And another dimension of this that you don’t see but is very important is that I can look back over time and see how those issues have moved around. Up until 2015, cybersecurity wasn’t on our list. And then you have two major health plans – 80-million-member record breach, 20-million-member record reach. So a 100 million members records have been lost to the dark side.

Mabel: So, it made the list.

Ferris: Right. And the fact that it’s number 10 doesn’t mean that it’s not important but other things have become more important. Number four is Value-Based Reimbursement. And World Healthcare Congress this week has talked a lot about value and clinical appropriateness of price and those issues.

Three years ago, value-based reimbursement was number one on our list. You could say: “Well it’s dropped in importance.” But in fact, if I look back over our conversations – and we have monthly webinars and do a lot of blogging and then we have quarterly executive roundtables where we take these issues and discuss them in our annual meeting, we spend a hold three days on the program. The discussion was: we can’t get to value-based payments until we have a better handle on data, and in particular, clinical data. We’ve got a lot of claims data but we need the clinical data and we need agreement on the majors and the outcomes and the data we’re going to track before we can get to value-based reimbursement.

RELATED: The 2019 HCEG Top 10 List of Healthcare Challenges, Issues & Opportunities

Of Course, Social Determinants of Health Are On the List

Ferris: We need to bring the consumer in. Number two is Total Consumer Health. Number three is labeled Population Health Services. We call it social determinants of health but it’s really the barriers to medical health that are non-medical. And we’ve narrowly defined healthcare as medical and it isn’t.opioid crisis, opioid management

Mabel: Well also, at number nine is Opioid Management.

Ferris: And that’s a new one this year.

Mabel: Yes. I can imagine it would be.

Ferris: Right

Mabel: But it’s a crisis and your executives are very concerned about this.

Ferris: They are. And on all of these issues. They’re corporate issues. In our discussions, many times they’ve evolved to: What are the systems? What are the data flows? What is the information? What is it that we’re trying to track that will help us, help our executive team address or better handle a crisis like opioid management?

Using the 2019 HCEG Top 10 List to Define and Frame Problems

And you know, from a technology point of view, you could say: “Well that’s a medical issue, it’s not a technology issue.” But, in fact, in our data for a number of years, there were indicators that this was becoming a problem and we didn’t analyze it.

Mabel: I see. Okay. So now that executives have outlined these as their concerns, what does your group do about that?

Ferris: Well, we’re very action-oriented. But to get to action you’ve got to be very sure you define the problem correctly and have the components of the solution in place before you take action. And so, a lot of what we’re focused on are, as a group, here’s what I’m doing from a system and a technology point of view to address each one of these issues.

And their colleague in another part of the country, somebody that they don’t compete against. So they can be very open and sharing are saying: “Well you know, in addition to that I’m doing this.” And the colleague may respond: “Oh, I hadn’t thought about that. I need to bring that to the table as well.” And then they can go to their management team in a very organized and comfortable way saying: “This isn’t just my idea. This is what a group of our colleagues that are similar to us is doing.”

RELATED: 2019 HCEG Top 10 Infographic

A Common Frame of Reference For Healthcare Leadership

And it gets better acceptance. It allows these things to become priorities within each company’s competitive marketplace because everybody’s different with their resources with the focus that they have on health care.

If you’re a Medicaid plan you have a different focus than if you’re a Medicare, commercial or a dual-eligible plan. So, it’s the networking that leads to the actions that can take place here.

Our closing session yesterday here at World Health Care Congress was two of our board members. Board chair Kim Sinclair from Boston Children’s Medical Center and Alan Abramson from Health Partners sharing with everybody here at World Healthcare Congress what they see out of these as their priority. And going into specifics: these are the things that we are doing to address the challenges that we’ve already acknowledged.

Mabel: All right.  Ferris, thank you so much for sharing your experience with HCEG. We appreciate it.

Ferris: It’s a lot of fun all right.

Mabel: Thank you for joining us stay tuned we’re rounding out our last interview very shortly.

Join Other Healthcare Leaders to Digitally Transform Your Organization

For more information, insight, and ideas about the challenges, issues, and opportunities facing healthcare leadership during these uncertain times, consider these opportunities:HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation. Annual Forum. HIMSS, AHIP, WHCC, MGMA, CHIME, WEDI, HLTH

  1. Subscribe to our eNewsletter
  2. Follow @HCExecGroup on Twitter
  3. Join us on LinkedIn
  4. Become an Individual Member of the HealthCare Executive Group – Use KickOffPromo here for a special, limited time $50 discount
  5. Join us in Boston, Massachusetts for 2019 Annual Forum on September 9th-11th, 2019

If you have any questions or comments, please contact us

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Recapping 16th Annual World Health Care Congress & CIO/CTO Strategy Track

By | HCEG Top 10, Partners, Social Determinants of Health, Value-Based Payment, WHCC | One Comment

Last week a lot of planning, coordination and content development by the HealthCare Executive Group came together at the 16th Annual World Health Care Congress in Washington, DC. For this year’s congress, HCEG partnered with World Congress Events to present the CIO & CTO Strategy Track. This post recaps a few highlights of the 2019 World Health Care Congress, shares some insight from the healthcare leaders and champions presenting at the event and in our the CIO & CTO Strategy Track, and provides some select presentation materials, recordings and other content from the event.

HCEG Top 10-Related Highlights From 2019 World Health Care Congress

As expected, many of the sessions and keynotes at the WHCC event addressed items on the 2019 HCEG Top 10 list with “social determinants of health” (#3 on the 2019 HCEG Top 10) and “value-based payment” (#4 on the 2019 HCEG Top 10) being pervasive themes throughout the keynotes, sessions and exhibit hall.

Value-Based Care – It’s More Than Just Adding An Alternative Payment Model

One of the sessions in the Provider Transformation track, ‘Do Medicare Changes Enhance or Hinder Clinical and Payment Transformation‘ emphasized the role of the primary care doctor in the shift from the dominant fee-for-service reimbursement model to new value-based-payment methods. Panelists also called out that to truly transform our health care system, change must not just focus on payment models but also deliver scalable clinical and operational methods. And HCEG members acknowledge this as “Operational Effectiveness” is ranked #8 on the 2019 HCEG Top 10 list.

Defining, Measuring, and Communicating Quality Measures are Key for Leveraging Social Determinants of Health

Another session titled “SDoH Business Strategy: Quantify and Communicate the ROI and VOI of SDoH Initiatives” shared the following key points and considerations for healthcare organizations looking to address social determinants of health as barriers to care:

  1. Quality measures that incorporate social determinants of health must be developed and understood BEFORE starting programs and initiatives.
  2. Readily available public data is not granular enough to capture SDoH factors needed appropriate quality measures.
  3. Conducting clinical trials on proposed quality measures can help to understand and quantify the benefits of SDoH initiatives.
  4. Incorporate patient/member personalization into a standardized, common infrastructure that enables economies of scale.
  5. Predictive analytics – a perennially high-ranking item on HCEG’s Top 10 lists – is THE critical component of SDoH programs.
  6. Combining clinical data from EHR’s with claims and other administrative/demographic data records allows health plans/health systems opportunities never before easily attainable.
  7. Health plans, health systems, and providers must clearly understand and communicate the benefit that addressing social determinants of health can have for their members and patients.
  8. Organizations should strive to assign a financial measure assigned to each quality measure.

CIO & CTO Strategy Track at World Health Care Congress

HCEG. Healthcare Executive group. WHCC. World Health Care Congress. CIO & CTO Strategy Track.

HCEG board chair Kim Sinclair, CIO at BMC HealthNet Plan and board member Alan Abramson, Sr VP of IT & CIO at HealthPartners and Co-Chair of the Minnesota eHealth Advisory Committee, shared some real-world examples of how they and their organizations are addressing some of the items on the 2019 HCEG Top 10 list.

Alan Abramson shared four areas of focus for HealthPartners:

  1. Formally chartering projects to deploy technology-based approaches to largely manual processes
  2. Carving out and focusing on efforts to improve patient experience
  3. Address inefficiencies in technology ecosystems, business policy, and processes
  4. Establishing R & D projects to assess opportunities and benefits of new, emerging technologies

Increasing Operational Effectiveness in Health Plans & Health Systems

Alan went on to share that the #1 initiative his healthcare organization has been focusing on last year, in 2019 and will continue to focus on in 2020, is increasing Operational Effectiveness (#8 on the 2019 HCEG Top 10). Alan provided some examples as to how HealthPartners is achieving greater operational effectiveness including:

  1. Utilizing Lawson Financials to consolidate multiple disparate functions
  2. Rehosting and re-platforming administration systems such as employer group setup, utilization management reporting, new member enrollment, and patient admission, discharge and transfer.
  3. Positioning systems, policies, and procedures to accommodate increases in individual health plan coverage
  4. Consolidating four different laboratory systems into one system
  5. Using Robotic Process Automation (RPA) to automate user administration and security
  6. Using AI-powered bots to automate 27,000 software QA tests that took three weeks to complete and that now take 17 hours.
  7. Alan noted that achieving success via ‘standardization’ in one area often leads to end users demanding improvement via standardization in other areas.HCEG. Healthcare Executive Group. WHCC. World Health Care Congress. CIO & CTO Strategy Track. Top 10. Industry Pulse

Payer-Provider Data Sharing and Interoperability Critical in Risk-Sharing Relationships

Kim Sinclair’s healthcare organization serves approximately 400,000 members and patients via its health plan, hospital, and medical centers – 80% of whom are Medicaid beneficiaries and represent 15% of the state’s Medicaid population.

Like other integrated healthcare delivery systems – especially those entering the nascent world of ‘accountable care,’ Kim noted that investments in provider network management and payer-provider interoperability have often lagged that of other initiatives. Moreover, a competitive market with many small medical practices lacking sufficient IT systems and a tendency to ‘throw bodies at a problem’ has increased the challenges her organization faces.

Kim also shared some examples of how her organization is addressing their challenges, issues, and opportunities:

  1. Integrating various systems with a focus on creating an industry-leading accountable care organization (ACO).
  2. Formal projects to identify and stratify members and patients with complex care management needs.
  3. Revising policies, procedures, teams, and systems to effect a truly integrated system.
  4. Reducing pended claims and time to pay – particularly important where both payer and provider are sharing risk.
  5. Focusing on change management and investing in payer-provider interoperability and support.

RELATED: Executives, Policymakers & Thought Leaders Address Healthcare Innovation and Disruption

Cybersecurity – Think Beyond Enterprise and Employee Training

In this CIO & CTO Strategy Track session, panelists discussed cybersecurity at the end-user level. They emphasized the importance of leadership having a strong grasp on the ‘foundational’ components of cybersecurity (patch management, identity/access management, perimeter security, etc.) And also encouraged the audience to pay attention to data assets outside their own four walls. For instance, the use of Software as a Services (SaaS) and 3rd parties they contract with (outsourced vendors) who possess their organization’s sensitive data.Cybersecurity. WHCC and HCEG HealthCare Executive Group, Tim Thull Medica Health Plan. CIO & CTO Strategy Track

HCEG board member Eric Decker and SVP of IT & CIO at Independent Health spoke about how his mid-sized health plan has evolved beyond the core technical cybersecurity team as the ‘first line of defense’ by chartering a Risk Office responsible for creating and testing their cybersecurity framework. His organization also has an Internal Audit team that regularly audits core controls as well as the cybersecurity framework.

Jothi Dugar, Chief Information Security Officer in the Office of the Director at the NIH Center for Information Technology shared what seems like an obvious approach to thinking about cybersecurity but may not, in fact, be so common:

Think holistically – consider the psychology of cybersecurity and how to optimize your workforce against threats.

Tim Thull, SVP of IT & CIO at Medica Health Plan spoke about how it is important to have strong oversight, governance, and controls framework around information risk management from your board of directors to individual staff. Medica has implemented HITRUST as common security framework with an information risk program which provides sound technology solutions and controls. Robust training and awareness remain a critical component in ensuring everyone is an active participant in strong cybersecurity defenses.

Optimize Information Sharing to Generate Real Value from Data

Latecia Engram, MSPH from the ReImagine HHS Data Insights Initiative/ACF Office on Trafficking in Persons at Health & Human Services presented the “Optimize Information Sharing to Generate Real Value from Data” session in the CIO & CTO Strategy track.

Latecia spoke about the importance of viewing data as a strategic asset, explained that “the ‘Why’ we share information matters”  and offered some lessons learned during the Opioid Symposium and Code-a-Thon sponsored by HHS.

  1. Data are in silos
  2. Data sharing is inefficient
  3. Analytics capacity is uneven
  4. Data sharing is costly

Video Interviews by Mabel Jong at 2019 World Health Care Congress

One of the interesting and informative parts of the WHCC event was their WHCC TV feature where Mabel Jong – professional on-camera interviewer and panel moderator specializing in healthcare – does short interviews with keynote speakers, session panelists, and other healthcare leaders and champions participating in the Congress.

WHCC19.Healthcare Executive Group. HCEG. Video Interviews by Mabel Jong. Ferris Taylor, Chief Operating Officer of Arches Health Plan and HCEG’s executive director. HCEG Top 10. Annual Forum.

Mabel interviewed Ferris Taylor, recent Chief Operating Officer of Arches Health Plan and HCEG’s executive director. More about this interview will be shared as the recordings are released. In the meantime, you can find many of the interviews performed by Mabel Jong on the World Congress Events YouTube Channel.

HCEG Member Feedback on 16th Annual World Health Care Congress

HCEG Board members Cate McConnell, Healthcare Payer Industry Practice Lead at Appian Corporation and Eric J. Decker, SVP of IT & CIO at Independent Health shared their insight on the 16th Annual World Health Care Congress:“Keynotes at the 2019 World Health Care Congress went right to the heart of issues impacting healthcare today: transparency, value-based payments, social barriers, member engagement, and affordability

What was unique about the WHCC event?

Eric: The keynotes went right to the heart of the issues impacting our industry today (transparency, value-based payments, social barriers, member engagement, and affordability).  Likewise, the breakout sessions were plentiful and offered a diverse array of topics to choose from.

Cate: WHCC, being in Washington DC, includes policymakers in greater numbers than most conferences. It was good to hear some of the interesting ideas shared by the policymakers. I would have liked to have more people from the current HHS/CMS administration who are shaping healthcare policy speak at WHCC.

How did WHCC’s event differ from what HCEG presents with its Annual Forum? 

Eric: Many healthcare conferences – WHCC included – include limited time for questions and answers, not only in the keynotes but also the breakout sessions. The event had nowhere near the time that HCEG’s forum includes for questions (and even debate).

Cate: WHCC is much bigger than HCEG’s annual forum which leads to fewer and less intense opportunities for networking and discussion. The large exhibit hall/show floor can sometimes be a distraction.

What didn’t you see or what could have been better about WHCC?

Cate: Pricing transparency is ‘critical’ in healthcare – in terms of procedures, tests, and drugs – but there weren’t any discussions of how to do this, and what this means to provider compensation. The free market disruptors will likely force this on the industry, which appears unwilling/unready to address it themselves. A speaker made the point that of the two industries that don’t have price transparency – college education and healthcare – prices increase many times greater than inflation because there are no incentives to become more efficient.

What were some things you felt were ‘most important’ for WHCC attendees to absorb?

Cate: Many speakers acknowledged that disruption is coming and that Amazon, Google, and Apple are the prime disruptors. Yet most executives shrugged off this threat with “they will learn healthcare is complex.” This seems to be an “innovator’s dilemma” situation where current industry players are unable to disrupt themselves due to entrenched business models. But what will happen to healthcare if Amazon drives sweeping disruption as it did in retail? Are we ready for widespread bankruptcies?

“External Market Disruption” is ranked #7 on the 2019 HCEG Top 10 list.

Other Recaps & Insight from 2019 World Health Care Congress

Here’s a bit about what others are sharing from the 2019 HCEG Top 10 list at the 16th Annual World Health Care Congress:

5 Things to Know From World Health Care Congress 2019 – Via AJMC

Unlocking Innovation in Value-Based Care – Via FierceHealthcare

How to speed up the shift from volume to value? – Via FierceHealthcare

How Bright Health is changing the payer-provider dynamic – Via FierceHealthcare

Trump likely to target Medicare in quest for lower drug prices – Via FierceHealthcare

Importance of Process Measures When Determining Value of SDOH Initiatives – Via AJMC

Gottlieb talks about lessons from opioid crisis in first speech since leaving FDA – Via FierceHealthcare

RELATED: Top Tweets from 16th Annual World Health Care Congress – #WHCC19

A Unique Opportunity for Healthcare Executives, Leaders & Champions

The 16th Annual World Health Care Congress was a great opportunity for those working to transform the healthcare industry during these uncertain times. And the HealthCare Executive Group was honored to have partnered with World Congress Events to host the new CIO & CTO Strategy Track.HCEG. Healthcare Executive Group. Annual Forum. Conferences for executives leadership. Events. Eventprofs.

For another opportunity to learn about new strategies and approaches to addressing the challenges, issues, and opportunities facing healthcare leaders – and to establish new relationships to facilitate your organization’s digital transformation – consider joining other healthcare executives, leaders, and champions at our 2019 Annual Forum in Boston on September 9th through the 11th. The year’s agenda is centered around the following major themes supported by the 2019 HCEG Top 10:

  • Technology & Its Role in Transformational Industry Change
  • Digital Health: Consumer & Organizational
  • Pharmacy Costs and Opioid Management

In addition, all participants in our 31st Annual Forum will be treated to a special networking event between the Boston Red Sox and the New York Yankees at Fenway Park on September 9th – at no additional charge.

Check out some photos, program guide and presentation materials from last year’s Annual Forum celebrating our 30th anniversary. And visit this page for more information and to register.

Leveraging Low-code Development Platforms to Increase Member Engagement. low-code tools, patient engagement, operational effectiveness, healthcare consumerism, customer centricity, Appian, healthcare executive group, HCEG

Using Low-Code Development Platforms to Boost Patient and Member Engagement

By | HCEG Top 10, Operational Efficiency, Sponsor, Tools, Total Consumer Health | No Comments

Health plan members and health system patients have become more vocal in their demands for clarity and measurable value from their healthcare services. Members see ever-increasing costs and continued transfer of those costs from employers to their employees. New direct to consumer entrants are changing the interaction paradigm. All of these factors are driving healthcare payers toward new ways of engaging with their members and providers.

HIMSS President and CEO Hal Wolf states, “Consumer pressure is driving a disruptive technology-enabled shift in healthcare today.” Accordingly, healthcare organizations and the companies supporting them are looking for ways to deliver their promise of value. This requires a better understanding of individual consumer preferences, better care coordinating, and better delivery across a broad health ecosystem.

New Generations of Healthcare Consumers are Demanding New Healthcare Services & Delivery Channels

In addition, digital generations—Millennials and Gen Z —are increasingly unsatisfied with how they obtain their healthcare services. Recent Accenture research1 found that one-third of millennials and almost half of Gen Z say they don’t have a primary care physician—compared to just 16% of baby boomers.  Millennials are shifting the historical relationship between physician and patient to virtual, retail clinics and digital self-service.

Enabling Total Consumer Health and Improving Operational Effectiveness

The HealthCare Executive Group Top 10 list of challenges, issues, and opportunities facing healthcare leaders in 2019 and healthcare executive group, HCEG Top 10, Challenges, Issues, Opportunities facing healthcare leadership. Innovation and disruption. Data & Analytics, Total Consumer Health, Population Health Services, Value-based Payments, The Digital Healthcare Organization, Rising Pharmacy Costs, External Market Disruption, Operational Effectiveness, Opioid Management, Cybersecuritybeyond reflects the importance of engaging health plan members and health system patients. Total consumer health—defined as improving members’ overall medical, social, financial, and environmental well-being—was ranked second on HCEG’s 2019 Top 10 list. And operational effectiveness—implementing lean quality programs, process efficiency, robotics automation, revenue cycle management, real-time/near-time point of sales transactions, and beyond—was ranked eighth.

It’s clear that healthcare organizations must rapidly develop services and products that engage healthcare consumers and help their organizations stay one step ahead of these major shifts in healthcare consumer preferences.

Address Changing Needs with Low-Code Application Development Platforms

Leadership charged with delivering healthcare products and services must address the changing needs of healthcare consumers in an agile, cost-effective way. Forward-thinking healthcare organizations are using low-code development platforms to digitally transform their organizations and efficiently respond to patient engagement opportunities.

What is a Low-Code Development Platform?

A low-code development platform2 allows you to build enterprise software applications using graphical user interfaces, drag and drop assembly and configuration. With low-code tools, you don’t write the application in traditional software code—you draw it like a flow chart. This greatly accelerates application development by orders of magnitude for both professional programmers and non-technical “citizen developers.”

Low-Code Platforms Enable Innovation, Accelerate Delivery and Improve Agility

Low-code platforms can help build applications that consolidate data, automate key processes, and enable mobile innovation. Instead of changing business operations to match the way commercial off-the-shelf (COTS) software works, companies can use to align their software systems with their business needs.

Leveraging Low-code Development Platforms to Increase Member Engagement. low-code tools, patient engagement, operational effectiveness, healthcare consumerism, customer centricity, Appian, healthcare executive group, HCEG

Low-Code Platforms Offer a Range of Benefits

  • Usability beyond software developers, easing the burden on IT
  • Extended existing applications and data across new channels and devices
  • Reduced IT sprawl, minimizing maintenance and related expenses
  • Flexibility to build new solutions using technology already owned
  • A fast and simple way to create powerful software

Key Features of High-Quality Low-Code Tools

While considering how your healthcare organization might speed up its digital transformation initiatives, keep in mind the key features of high-quality low-code tools include:

  • A single interface that ties together disparate systems so you can work no matter where data is stored
  • Enhanced security through a HIPAA compliant cloud
  • An API to allow drag-and-drop design to build your app once, then easily deploy to any device
  • Easy automation across people, robots, and machines

Areas Where Low-Code Platforms Can Quickly Add Value

No single commercial-off-the-shelf (COTS) software system can address all the member- and patient-related engagement opportunities that healthcare organizations face—at least not without high expenses and potentially long wait times for vendors to add functionality to their product. In addition, many COTS systems don’t integrate with other COTS and the myriad custom-developed systems healthcare organizations typically have installed.

Low-code development platforms can address many member- and patient-related business and functional needs. Capabilities include:

  • Integrating clinical data from providers with financial data from payers
  • Maintaining accurate and complete provider directories
  • Aggregating data to better coordinate patient services
  • Creating member- and patient-facing apps for scheduling services and accessing financial and clinical records
  • Providing real-time support for admissions and discharges
  • Handling complaints, appeals, and grievances automation
  • Managing simple, automated utilization and prior authorizations to ensure members understand what’s covered under their plans
  • Understanding out-of-pocket costs prior to obtaining services to help increase member satisfaction

More About Leveraging Low-Code Development Platforms

There are a number of good resources and references on low-code development platforms:

The Best Low-Code Development Platforms for 2019

Low-code platforms: A cheat sheetLeveraging Low-code Development Platforms to Increase Member Engagement. low-code tools, patient engagement, operational effectiveness, healthcare consumerism, customer centricity, Appian, healthcare executive group, HCEG

What Really Is Low-Code/No-Code Development?

The Forrester Wave™: Low-Code Development Platforms

And some use cases and case studies on using low-code development tools to enhance member and patient engagement:

Member Services, Enrollment, & Relationship Management

Intelligent Contact Center for Healthcare Organizations

Member Engagement & Wellness for Healthcare Payers

Transform Member & Patient Engagement Using Low-Code Application Development Platforms

The future of healthcare depends upon the ability to quickly adapt and provide quality and convenience for providers, payers, and most importantly, health plan members and health system patients. It takes speed and power to deliver transformational healthcare solutions. Low-code application development platforms provide both – enabling organizations to build web and mobile apps faster, run them on a HIPAA-compliant cloud, and manage complex processes, end-to-end, without limitations.

For more information on how to address opportunities, challenges, and issues in today’s rapidly transforming healthcare environment, consider subscribing to our eNewsletter and checking out the products and services offered by our sponsor partners – including Appian, a leading provider of low-code application development platforms.

Announcing Individual Membership in HealthCare Executive Group

By | Annual Forum, Conferences, Executive Leadership Roundtable, HCEG Top 10, Member Benefits, Webinar Series | No Comments

The HealthCare Executive Group (HCEG) is a professional association chartered to convene and support executive leaders of health plans, health systems, and provider organizations. Since the HealthCare Executive Group’s inception over 30 years ago, HCEG has offered membership to organizations providing direct insurance benefits and/or direct health services to groups or individuals, either as stand-alone entities or as subsidiaries under a commercial entity. Anoffid starting today, we’re announcing two new individual membership options for healthcare executives and leaders: Individual Membership and Alumni Membership. HCEG is retaining the existing Organizational Membership option for healthcare organizations preferring that option.

New Membership Options in HealthCare Executive Group

These two new membership options provide a pathway for more people to become part of the HealthCare Executive Group on a cost-efficient basis.

Individual Membership

Alumni Membership

Candidates are executives from Payer/Provider Membership eligible organizations.Past HCEG members who are unaffiliated with vendor organizations. Vendors provide products and services to HCEG member candidate organizations to better serve individuals.

For a very reasonable investment, healthcare executives and others leading the transformation of the healthcare industry can obtain benefits that can provide outsized returns on that small investment – only $99 dollars for a limited time!

Why Healthcare Leaders Should Join the HealthCare Executive Group

Individual Membership and Alumni Membership offer a variety of benefits all year round: Professional Networking & Relationships, In-Person/Live Events, Professional Development Opportunities, Resources, Research & News, and discounts to popular healthcare conferences.

Throughout the year, members can leverage HCEG’s platform, content, events, professional development, and networking opportunities to help them optimize their time, stay up to date on industry issues, enhance leadership skills, and obtain valuable resources to share with their staff and help transform their healthcare organization.

Professional Networking & Relationships for Healthcare Executives2018 HealthCare Executive Group Annual Forum. 30th-anniversary. Hewing Hotel Minneapolis, MN. Healthcare Industry Executive Leaders

Our members have unparalleled, year-round networking opportunities centered upon a calendar of events and content identified and defined by HCEG members and updated throughout the year via input and research from members and sponsor partners. Our mission and focus are to provide the platform, channels, content and on-going support for convening and connecting our members with their peers, industry thought leaders, and other resources critical to the transformation of the healthcare industry.

In-Person/Live Events for Healthcare Leaders Transforming Healthcare

HCEG offers its members various opportunities to connect with peers and other industry leaders in live, face-to-face venues throughout the year. These events are typically free to HCEG members or are discounted based on HCEG membership.

Executive Leadership Roundtables

Our quarterly Executive Leadership Roundtables (ELR) are bundled with popular healthcare conferences like the AHIP Institute and HLTH Forum. These ELR’s are intimate, participatory opportunities to learn from prominent industry thought-leaders, share ideas and obtain advice and real-world experience from others.HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation.

HCEG Annual Forum

As an Individual Member or Alumni Member, you’ll receive discounted registration to our Annual Forum held in September of each year. Our Annual Forum is our marquee event and includes not only prominent keynote speakers but also unique extracurricular networking opportunities. Check out this recap of the 2018 Annual Forum celebrating HCEG’s 30-Year Anniversary.

Individual & Alumni Member Discount to 2019 Annual Forum

After registering as an Individual Member or an Alumni Member and paying the membership fee, new members receive a discount code (via pop-up window and email) to HCEG’s 2019 Annual Forum. This code can be used immediately or at a future date.

Also, and you’re hearing this for the first time here, HCEG members attending our 2019 Annual Forum in Boston, MA on September 9th through 11th will enjoy a very unique, uncommon extracurricular networking event. For more information on what this event includes, contact us.

HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation. Annual Forum. HIMSS, AHIP, WHCC, MGMA, CHIME, WEDI, HLTH

Partner Events

HCEG members are offered preferential, discounted access to leading healthcare gatherings like the World Health Care Congress, the HLTH.co Forum, WEDI Conferences, and other industry events. Just one of these discounts alone is worth more than the cost of HCEG’s individual membership.

RELATED: What’s In Store for HealthCare Executive Group Members in 2019?

Thought-Leadership & Professional Development Opportunities for Healthcare Executives

In addition to quarterly ELR’s, our Annual Forum, and partner events, HCEG also offers our members various opportunities for participating in webinars, research surveys, blog posts, and other knowledge sharing channels.

Webinars & Online Discussion Group Opportunities for Healthcare Executives

In addition to attending HCEG’s monthly Webinar-Series events, HCEG members have the opportunity to help define webinars and serve as panelists.  In addition, HCEG hosts period online discussions and encourages member participation as an important way for members to demonstrate their thought leadership and grow their network.

Research Surveys for Healthcare Executives & Thought-Leaders

HCEG Top 10 List

Members participate in defining and ranking the HCEG Top 10 List of Challenges, Issues, & Opportunities during HCEG’s Annual Forum. HCEG members, staff and partners then expound on this list and it serves as the basis for content programming going forward.

Industry PulseHealthCare Executive Group. Top 10. HCEGTop10. Industry Pulse. Leaders. Trends in Healthcare Digital Transformation. Annual Forum, Executive Leadership Roundtables. ELR, Professional Networking & Relationships, In-Person, Live Events, Professional Development Opportunities for Healthcare Executives, and Resources, Research & News

The Industry Pulse research survey is based on the HCEG Top 10 and administered in a partnership between HCEG and sponsor partner Change Healthcare. The 9th Annual Industry Pulse was just released last week and promises to be a source of many reviews, discussion, and elaboration over the coming months and year.

Knowledge Creation, Content Sharing & Promotion for Healthcare Executives

Our members enjoy the opportunity to share information, insight, and ideas with each other and the industry at large via various HCEG channels including our blog, bi-weekly eNewsletter, and social channels. In addition, HCEG promotes certain member insight and content to amplify member content on best practices, new ideas, breaking news, and key advancements.

Become a HealthCare Executive Group Member Today

HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation.

As uncertainty continues its grip on healthcare in the United States and new digital technologies advance digital transformation opportunities, it’s more important than ever for healthcare leaders to stay abreast of important industry trends, challenges, and opportunities.

Value Well Beyond Conferences, Webinars, & Content

Individual membership in the HealthCare Executive Group is a very cost-effective way for healthcare leaders to reduce uncertainty, stay up to date on changes within their field, and help to transform their organizations.

Special Discount on HCEG Individual Membership

As an additional incentive to join HCEG as an individual, we’re offering a $50 discount off the regular $149 per year rate for a limited time.  Use KickoffPromo to expand your knowledge and grow your professional network for only $99! HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation.

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Executives, Policymakers & Thought Leaders Address Healthcare Innovation and Disruption

By | Conferences, HCEG Top 10, Partner Events, The Industry Pulse | One Comment

The HealthCare Executive Group (HCEG) has been convening and supporting leaders of health plans, health systems, and provider organizations for over three decades. Similarly, and for nearly two decades, the World Health Care Congress has been connecting leaders from all parts of the health care ecosystem to catalyze and support relationships that ultimately transform the delivery, affordability, and quality of health care. And next month starting April 28th, the 16th Annual World Health Care Congress (WHCC) convenes in Washington, DC with over 1,500 of the industry’s best and brightest minds gathering to learn from peers, form new relationships, share insights and strategies, and discuss policy, innovation, and disruption impacting individual organizations and the healthcare industry as a whole.

Special discount to 16th Annual World Health Care Congress when registering with HCEG2019

HCEG Partners with WHCC on CIO & CTO Strategy Track

In this year’s 2019 World Health Care Congress, the HealthCare Executive Group is pleased to partner with WHCC to provide and moderate the CIO & CTO Strategy Track – a series of sessions designed to bring together policymakers, technology leaders, and health plan and health system professionals supporting enterprise decisions around information technology. The sessions presented in this track will be based on select items on the 2019 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leaders.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

This post provides some insight into CIO & CTO Strategy Track sessions, the healthcare champions who will be presenting and participating in the various sessions, and presents a unique discount offer for HCEG members and associates considering attending this high-profile healthcare event.

Digital Technology – The Foundation of Healthcare Innovation and DisruptionHealthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

While most of the sessions at the WHCC are focused on strategy, leadership, business transformation, and policy, the sessions in the CIO & CTO Strategy track will share insight, ideas, and actionable information on digital technology-related topics identified by HCEG members and associates in the 2019 HCEG Top 10 list – specifically:

  • Data Analytics (Top 10 Item #1)
  • Importance of Useable Technology (Top 10 Item #5)
  • Pharmacy Costs and Transparency (Top 10 Item #6)
  • External Market Disruptors (Top 10 Item #7)
  • Cybersecurity (Top 10 Item #10)

In addition, HCEG’s board chair Kim Sinclair, executive director Ferris Taylor, and board member Alan Abramson will share insights on the 2019 HCEG Top 10 list of primary challenges, issues, and opportunities.

Technology-Focused Sessions Supporting Healthcare Innovation and Disruption

There are eighteen different tracks at the 16th Annual World Health Care Congress – something for everyone that can be mixed and matched to meet specific areas of interest and need. Use HCEG2019 when you register here to receive a discount not generally available to everyone.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Here are the sessions in the CIO & CTo Strategy Track that HCEG has partnered with the World Health Care Congress to present:

Optimize Information Sharing to Generate Real Value from Data (HCEG Top 10 Item #1)

Tues, April 30th at 11:25 am

Latecia Engram, Lead of the ReImagine Data Insights Initiative at HHS’s Office of the Chief Technology Officer will share a first-hand overview of how HHS assessed its information sharing processes and developed a roadmap for greater efficiency and effectiveness. Latecia will also share insight into the foundational work that must happen before any organization can truly use data as an asset.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

How Do You Value a Life Saved? – Pharmacy Costs and Transparency (HCEG Top 10 Item #6)

Tues, April 30th at 1:35 pm

Lynn Hanessian, Board Member at the Center for Healthcare Innovation (CHI) will moderate a discussion with Nichole White, VP of Health Services at Medica and David A. DiLoreto, MD, HCEG board member and Principal at Sg2. They’ll discuss how outcomes and costs associated using technology to increase transparency and value in the fastest growing segment of healthcare costs – pharmacy.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Useable Tech: Develop and Deploy Solutions that Fit into Your Member’s or Patient’s Life (HCEG Top 10 Item #5)

Mon, April 29th at 1:40 pm

Brett Trusko, Founder of the International Association of Innovation Professionals (IAOIP) and Editor-in-Chief of the International Journal of Innovation Science and Kevin Pereau, Founder and CEO of Transcend IT Health will discuss technology’s role in addressing member and patient needs.

Insight and examples of why using technology for technology’s sake simply do not work will be shared along with a discussion of machine language and artificial intelligence’s promise in flagging fraudulent activity more quickly; alleviating waste and abuse.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Cybersecurity – Think Beyond Enterprise and Employee Training (HCEG Top 10 Item #10)

Mon, April 29th at 2:30 pm

Jothi Dugar, Chief Information Security Officer in the Office of the Director at the NIH Center for Information Technology will join HCEG board member Eric Decker, Sr VP of IT & CIO at Independent Health, and HCEG Secretary Tim Thull, Sr VP & CIO at Medica to discussion cybersecurity – ranked #10 on the 2019 HCEG Top 10.

Discussion topics include:

    • Addressing cybersecurity at the end-user level by considering the psychology of cybersecurity and how to optimize your workforce against threats
    • What’s holding health care back from sophisticated approaches to providing private, secure PHIHealthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Healthcare Innovation and Disruption Highlighted in HCEG Top 10 List & Industry Pulse

On Tuesday, April 30th at 2:25 pm, HCEG board chair Kim Sinclair, CIO at BMC HealthNet Plan, executive director Ferris Taylor, and board member Alan Abramson, Sr VP of IT & CIO at HealthPartners and Co-Chair of the Minnesota eHealth Advisory Committee will present ‘The HCEG Reveal: What CIOs and CTOs Care about Most in 2019 (and Why You Should Too).’ In this session, an overview and their insight on the 2019 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2019 will be shared including an overview of the impact the HCEG Top 10 can have on members, patients, providers, and others in our increasingly digital world.

The 9th Annual Industry Pulse Survey – Perspectives on Healthcare Innovation and Disruption9th Annual Industry Pulse survey. 2019 HCEG Top 10 List. Top challenges, issues and opportunities facing healthcare leadership.

Attendees of ‘The HCEG Reveal’ session will also enjoy insight and commentary on the 2019 Industry Pulse research survey – an annual survey based on the 2019 HCEG Top 10 and scheduled for release in the weeks before the World Health Care Congress event. This 9th instance of the Industry Pulse looks not only at the marketplace challenges, trends, opportunities, and investments reported by industry leaders but also compares and contrasts those findings with what was uncovered in past Industry Pulse surveys.

RELATED: The 2019 HCEG Top 10 List of Healthcare Challenges, Issues & Opportunities

More Details on 16th Annual World Health Care Congress and CIO & CTO Strategy Track

Here’s additional information on the 16th Annual World Health Care Congress. Feel free to reach out to us or contact WHCC if you have any questions regarding registration for this world-class healthcare event.

Conference WebsiteConference BrochureAgendaAgenda Snapshot
SpeakersEvent Hashtag: #WHCC19Twitter: @WHCCEventsContact WHCC

Special Discount for HCEG Members & Associates

HCEG is pleased to offer its members and associates a special discount to this year’s 16th Annual World Health Care Congress. Use HCEG2019 when you register here to receive a discount not generally available to everyone.Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Connect w/ HealthCare Innovators and Disruptors at 16th Annual World Health Care Congress

As uncertainty retains its grip on the healthcare sector, healthcare leaders now – more than ever – need to stay on top of the policies, regulations, technologies, and trends shaping the market. Consider joining your peers at the 16th Annual World Health Care Congress on April 28th in Washington, DC and register today!

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Stay Connected with HealthCare Innovators and Disruptors

Healthcare leaders and those championing the transformation of healthcare can subscribe to our eNewsletter to stay abreast of information, events, and networking opportunities in 2019 and beyond.

RELATED: What’s In Store for HealthCare Executive Group Members in 2019?