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Total Consumer Health & The Digital Healthcare Organization in Nashville

By | 2-Total Consumer Health, AHIP, Annual Forum, Conferences, Executive Leadership Forum, HCEG Top 10, Total Consumer Health | One Comment

The trend toward healthcare consumerism and digital health is driving what health plans, health systems, and healthcare providers are offering – or in the process of offering – their plan sponsors, the members those plan sponsors serve and the individuals participating in the U.S. healthcare market. Indeed, Total Consumer Health and The Digital Healthcare Organization are ranked #2 and #5 respectively by health insurance, health system and healthcare providers on the 2019 HCEG Top 10. Moreover, these two items and their closely aligned variations have ranked in the HCEG Top 10 for the last decade.

It’s obvious that healthcare consumerism and digitally-enabled organizations are front and center on the mind of healthcare leaders. Digitally transforming their organizations with a focus on facilitating consumerism is critical for all healthcare leaders.

Join Digital Healthcare Leaders & Forum Attendees in Nashville

HCEG’s Executive Leadership Roundtable events are held in intimate, informal and free-flowing settings where the exchange of facts, ideas, and questions are encouraged between roundtable panelists and participants. Our roundtables provide a safe space where participants can find common ground, obtain insight to solve problems and achieve results for those with different needs and views. The fact that our ELR’s are complimentary, free of vendor-speak and offer food and beverages are an additional benefit.Healthcare Executive Leadership Forum at Guidewell Innovation CenterParticipants at our roundtable event immediately following the closing of the 2018 AHIP Consumer Experience & Digital Health Forum (AHIP CDF) will enjoy the unique perspective and long-running insight of two distinguished panelists: Brian Lobley, President, Commercial and Consumer Markets at Independence Blue Cross and Stuart Hanson, Managing Director, Head of Healthcare Payments at JPMorgan Chase & Co.  And HCEG’s Executive Director Ferris Taylor will moderate the roundtable.

Brian LobleyStuart HansonFerris Taylor
healthcare consumerism. Digital health. Health plans, health systems, and healthcare providers. Total Consumer Health and The Digital Healthcare Organization. 2019 HCEG Top 10stuart hanson healthcare payments JP Morgan Chase HCEG Healthcare Executive grouphealthcare consumerism. Digital health. Health plans, health systems, and healthcare providers. Total Consumer Health and The Digital Healthcare Organization. 2019 HCEG Top 10
President, Commercial & Consumer Markets at Independence Blue CrossManaging Director, Healthcare Payments at JPMorgan Chase & CoHCEG Board Chair & COO/Consultant at Arches Health Plan

Healthcare Consumerism & Digital Healthcare

Brian Lobley and Stuart Hanson will share their insight and engage ELR participants on expanding the overall theme of the AHIP’s Consumer Experience & Digital Health Forum. Tentative topics that will be discussed include:

  1. Insight into how healthcare organization can enhance member/patient engagement
  2. How competition from new entrants, cost containment pressures associated with value-based programs, health/entitlement reforms, and technological innovations may impact ‘healthcare consumerism’
  3. Approaches for turning passive health plan members and health system patients into active healthcare consumers
  4. Catalysts for healthcare consumerism change: employer groups demanding better value and trend of health plan members and individuals directly engaging with plans and providers
  5. How value-based relationships demand that healthcare organizations engage with their members and patients

To be sure, HCEG roundtables are free-flowing interactions with heavy attendee participation and they often take a direction of their own. There’s a good chance that the above pre-planned topics may take a turn toward what participants share with Brian, Stuart, and Ferris.

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

Your attendance at healthcare conferences can be a non-trivial expense. By taking just a few extra hours of your time at the AHIP CDF, you may extend the value of your AHIP registration, travel and lodging investment.  And if you’re not attending the AHIP CDF in Nashville but have a few hours to join other healthcare executives, industry leaders and AHIP CDF participants in an intimate venue at our Executive Leadership Roundtable. your also welcome to attend our Executive Leadership Roundtable – complimentary also.Healthcare Executive Leadership Forum at Guidewell Innovation CenterIf you have any questions about this Executive Leadership Roundtable event at the AHIP Consumer Experience & Digital Health Forum in Nashville, please contact us.

Note: Our ELR will end at approximately 3:00 pm CT to allow participants plenty of time to get to the Nashville Airport to board late afternoon flights. 

Get a Discount off Registration to AHIP’s CDF

HCEG’s luncheon roundtable taking place on Thursday, December 13th, the last day of the AHIP CDF, is complimentary. If you’re interested in attending AHIP’s forum on December 10th through mid-day on the 13th, you can use code ‘HCEG’ to receive a discount off your AHIP CDF registration here.

RELATED: Total Consumer Health & The Digital Healthcare Organization in 2019


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

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


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

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

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

Thanks to Hosts & Participants!

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

Insight, Ideas and Opinions on Topic #1

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

Precision Medicine – aka. Personalized Medicine

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

Patients, Consumers & Health Plan Members

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

Importance of Basic Health Education, Literacy & Preventive Care

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

Customer Relationship Management

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

Data is Critical to Healthcare

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

The Importance of Home & Social Determinants of Health

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

Quality Measures & Measuring Outcomes

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

Look for More on the Other Topics in Following Posts

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

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

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

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

Leveraging Medical, Social and Other Data

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

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

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


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

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


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

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

Harry Merkin – Vice President, Marketing, HealthEdge

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