HCEG. What Should Be Keeping Health Care Executives up at Night? 2019 AHIP Consumer Experience & Digital Health Forum Dr. Esteban López, MD, MBA, Ian K. Gordon, Consumer Experience, Digital Health. Social Determinants of Health. SDOH. Health Plans.

Highlights of 2019 AHIP Consumer Experience & Digital Health Forum

By | AHIP, Conferences, Consumer Experience, HCEG Top 10, Social Determinants of Health | No Comments

Consumer Experience has been a high-ranking item on HCEG’s Top 10 list of challenges, issues, and opportunities facing healthcare leaders over the last decade.  And last week, 500+ healthcare industry professionals gathered in Chicago at the 2019 AHIP Consumer Experience & Digital Health Forum to present and discuss the importance of the healthcare consumer experience and various approaches to leveraging digital health platforms and tools to effect an improved consumer experience.

In this post, we’ll share some highlights from AHIP’s Consumer Experience & Digital Health Forum including:

Look forward to 2020 and more information and insight shared by healthcare industry leaders, innovators, and change-makers improving healthcare and health delivery.

What Should Be Keeping Health Care Executives up at Night?

As costs continue to rise, more financial responsibility is shifted to individuals, and non-traditional companies disrupt the traditional healthcare space, executives and industry leaders are under tremendous pressure to transform their organizations due to the challenge of providing coverage for healthcare services offering reasonable outcomes at a fair price.

Check out this blog post to learn more about the following topics addressed by three health industry leaders: Ian K. Gordon, Dr. Esteban Lopez, and Ferris Taylor:

• How challenges, issues, & opportunities have evolved over the last few years
• How they’re transforming and innovating their organizations
• What excites them about the future for health care
• How health plans help support health care consumer’s
• How socioeconomic status and social determinants of health impact health plans
• The role of health plans in addressing the social determinants of health and what work they’re doing
• What they’re doing right and what do they need to do better
• What them up at night with respect to the policy actions or industry trends

How Technology Innovation Will Play a Critical Role in Prevention

In the session titled “How Technology Innovation Will Play a Critical Role in Prevention” at last week’s 2019 AHIP Consumer Experience & Digital Health Forum in Chicago, a gaggle of industry leaders, innovators and change-makers shared their thoughts and ideas on the critical role new innovations in technology will play in preventing serious injuries among the fastest-growing demographic—aging Boomers.

Neel Mehta from Honor moderated a panel consisting of Bryan Adams of Best Buy Health, Dr. Ari Melmed, MD of Kaiser Permanente Colorado, Rajeev Ronanki from Anthem, and Faraz Shafiq of Cambia Health Solutions. The panel shared their take and experiences on the following:

• Latest innovations that can help keep older adults healthy and safe in their homes
• The impact technology might have on the social determinants of health
• How these technology innovations can result in better outcomes for well-being

Read this post for Highlights on How Technology Innovation Will Play a Critical Role in Prevention of Accidents and Disease

Creating Impactful Member Enrollment Correspondence

HCEG member Sheri Johnson, AVP of Member Enrollment and Billing joined fellow UCare AVP of Customer Service Julie Feirtag presented how their company utilized a cross-functional approach to update member enrollment-related correspondence to improve member engagement and experience, drive member action and support the customer service team.

See this sample of select slides on how Sheri and Julie orchestrated a team to define and employ simple language and standard templates to transform enrollment-related letters into actionable, easy-to-understand correspondence. And check out a few of the specific processes used, steps taken, changes made, and outcomes achieved they shared in their session.

Connect with Healthcare Industry Executives, Leaders, Innovators & Change-Makers

We’ll be sharing more from last week’s AHIP CDF in the coming weeks. For more information, insight, and ideas on healthcare innovation and the transformation of healthcare, subscribe to our eNewsletter and consider becoming a member of the HealthCare Executive Group.

Prevention. How Technology Innovation Will Play a Critical Role in Prevention. 2019 AHIP Consumer Experience & Digital Health Forum. Neel Mehta. Honor. Bryan Adams. Best Buy Health. Dr. Ari Melmed, MD. Kaiser Permanente Colorado. Rajeev Ronanki. Anthem. Faraz Shafiq. Cambia Health Solutions. social determinants of health. SDOH

How Technology Innovation Will Play a Critical Role in Prevention (of Accidents & Disease)

By | AHIP, Conferences, Consumer Experience, Population Health, Social Determinants of Health | One Comment

In the session titled “How Technology Innovation Will Play a Critical Role in Prevention” at last week’s 2019 AHIP Consumer Experience & Digital Health Forum in Chicago, a gaggle of industry leaders, innovators and change-makers shared their thoughts and ideas on the critical role new innovations in technology will play in prevention (of accidents & disease) among the fastest-growing demographic—aging Boomers joining original Medicare and Medicare Advantage programs at the rate of 10,000 new beneficiaries a day.

Neel Mehta from Honor moderated a panel consisting of Bryan Adams of Best Buy Health, Dr. Ari Melmed, MD of Kaiser Permanente Colorado, Rajeev Ronanki from Anthem, and Faraz Shafiq of Cambia Health Solutions. The panel shared their take and experiences on the following:

  • Latest innovations that can help keep older adults healthy and safe in their homes
  • The impact technology might have on the social determinants of health
  • How these technology innovations can result in better outcomes for well-being

The remainder of this post shares a few highlights from the session. Access all recordings mentioned in this blog post here.

Highlights on How Technology Innovation Will Play a Critical Role in Prevention

The following are some of the questions that moderator Neel Mehta presented to the panel and some panelist responses to those questions. You can listen to the entire recording – admittedly not of the best quality but still enlightening – here. Specific starting and ending points in the recording are noted below and link to the audio recordings.

Q1: How do health plans support caregivers? (02:24 – 04:30)

Fariz Shafiq: On average, caregivers provide 32 hours a week of unpaid caregiving, essentially a full-time, unpaid job imposing a financial and emotional impact on the caregiver. As a health plan, we recognize that caregiving is an extremely important service. Fariz shared how his organization equips caregivers best:

  • Help with scheduling appointments and checking the efficiency of patient schedules
  • Reconciling medications
  • Help with understanding and paying bills

Rajeev Ronacki: Keeping on top of local resources is a real challenge. We provide members and patients digital apps and help identify and connect members and patients with community-based orgs that can assist them. And we provide an online marketplace where members and patients can also self-serve.

Tech and Touch Must Be Balanced for Innovative Prevention of Accidents & Disease

Q2: The elderly caregiver population, whether it’s home care, provider or family member, are difficult to reach and engage with, regardless of whether they are tech-savvy or not. What are some of the ways you reach this population? (06:45-08:47)

Prevention. How Technology Innovation Will Play a Critical Role in Prevention. 2019 AHIP Consumer Experience & Digital Health Forum. Tech vs. Touch. Wearables. Telehealth. Social determinants of health. SDOH

Bryan Adams: Everything starts with balancing the tech vs. touch concept. We want to leverage technology into the home and surround that with robust services. This will ultimately move the needle not only for the healthcare consumer but also for the healthcare system as a whole.

We have ‘healthcare caring centers’ staffed by people encouraged and trained to have a high level of empathy interaction. Mostly telephonic relationships that establish and nurture a tech vs. touch relationship with the senior.

Q3: One of the things that is appealing to tech innovation in healthcare is Artificial Intelligence. What do you think in your perspective as a provider is the role of the healthcare provider in respect to AI? (08:53-12:53)

Dr. Ari Melmed: It’s a new time for providers and physicians. The role of the provider is to partner with the patient and to address their concerns. To get them the right answers. The amount of information available to everyone online is overwhelming. Staying up to date as a physician nowadays only takes 21 hours a day.

Faraz Shafiq: Computers are helping doctors getting better at diagnoses. Healthcare is so complex and the volume of information so great and often so nuanced that AI-powered assistance is needed.  (10:42-12:09)

RELATED: How Cambia Health Solutions is Leveraging Artificial Intelligence in Healthcare Space

Using Technology & Data to Understand Social Determinants of Health

Q4: I have found that on the medical side there’s a mountain of data. And on the social side there’s a huge and growing amount of data. How can technology support the understanding of how social and community health factors influence outcomes? (13:10 – 15:00)Prevention. How Technology Innovation Will Play a Critical Role in Prevention. 2019 AHIP Consumer Experience & Digital Health Forum. Tech vs. Touch. Wearables. Telehealth. Social determinants of health. SDOH

Rajeev Ronacki: I think the question is what do we do about it? How do we react to it? How do we make it more democratized?

Listen to more of Rajeev’s response here.

Q5: What are some of the challenges in integrating data, making it uniform, and making it ‘analyzable?’ (15:33-19:18)

Rajeev Ronacki: Roughly 80% of the work we need to do on any AI initiative is data prep: obtaining the data, looking at the quality of data, cleansing and integrating it, creating standards for uniformity. There’s nothing secret about it.

Listen to other responses to this question here.

Brick & Mortar Bring Human Interaction and Touch to Accident & Disease Prevention

Prevention. How Technology Innovation Will Play a Critical Role in Prevention. 2019 AHIP Consumer Experience & Digital Health Forum. Tech vs. Touch. Wearables. Telehealth. Social determinants of health. SDOH. Brick and Mortar

Q6: What unique value do brick and mortar companies bring to healthcare? (20:20 – 23:20)

Bryan Adams: Brick and mortar locations enable the touch component of the critical need to balance technology and human touch/interaction mentioned before. This is particularly important for the senior population.

Being entrenched in the neighborhood and being involved with community care initiatives helps us to better understand and capture social determinants of health unique to that area and then take that information and make it actionable. At our company, we’re giving thought on how to leverage our Geek Squad (20,000 people) and over 1200 retail outlets to engage with health plan members and to advance preventive care.

Q7: If telehealth has not yet reached into the home it is gaining a footprint in places like Best Buy, Walmart, and Walgreens. Are you seeing brick and mortar playing a part in expanding the reach of telehealth? (23:40 – 25:20)

Dr. Ari Melmed: Yes. And there are different ways of thinking about telehealth like onsite work clinics which are playing an important role, schools are developing innovative programs, remote clinics are interfacing with centralized, specialized services.

Q8: How has the Medicare market shifted in trying to support senior’s health?  (25:24 – 28:50)

Rajeev Ronacki: Increasingly there’s a consumer preference to do things in the home – particularly in the transition to and from the hospital.

Using TV’s and sensors and voice-assistance to deliver the care that’s needed. I would venture to say that 60-70% of the care that doesn’t need active intervention can be provided in the home. The question is how to deliver it in a way that makes sense.

Bryan Adams: Medicare Advantage as a whole has become a hub of innovation and we’re excited about SSBCI and opening up the ability to address social determinants. (27:31 – 28:38)

Can Technology Address 50% of Preventive Health Measures?

Q9: As Rajeev mentioned, with the right technology 60-70% of the care that doesn’t need active intervention can be provided in the home. What will it take to get to widespread adoption of the minimum technology infrastructure needed to address 50% of preventive medicine? (28:50 – 32:13)

Rajeev Ronacki: Some sort of super simple, USB-type device that’s widely adopted by consumers. Installation and implementation need to be simplified and cost-effective.

Prevention. Preventive Medicine. Primary Care. Care Coordination. SSBCI. Medicare Advantage. How Technology Innovation Will Play a Critical Role in Prevention. 2019 AHIP Consumer Experience & Digital Health Forum. Tech vs. Touch. Wearables. Telehealth. Social determinants of health. SDOH. Brick and Mortar

Listen here from more on how technology in the home may address 50% of preventative medicine.

Q10: Are there any examples of technologies that are starting to scratch the surface of being pretty easy to use? (33:35 – 38:50)

Rajeev Ronacki: Wireless sensors and other devices are becoming increasingly sophisticated and easy to use.

Bryan Adams: Passive devices that operate in the background and do not require the member/patient to do anything special or change any behavior. Devices that measure ADL’s and allow the member/patient to keep living their life without any special attention.

Dr. Ari Melmed: Devices that provide feedback on a real-time basis to drive behavior change. Tools to extract information from medical records and help the physician more quickly understand salient aspects of the patient.

Connect with Healthcare Industry Executives, Leaders, Innovators & Change-Makers

For more information, insight, and ideas on healthcare innovation and the transformation of healthcare, subscribe to our eNewsletter and consider becoming a member of the HealthCare Executive Group.

2019 AHIP Consumer Experience & Digital Health Forum. Healthcare Consumer Experience. 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2020. health plans, health systems, providers. Healthcare Predictions & Trends for 2020. HCEG. HealthCare Executive Group.

Healthcare ‘Costs & Transparency’ and ‘Consumer Experience’ – Top of Mind for 2020 & Beyond

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‘Costs & Transparency’ and ‘Consumer Experience’ are ranked in the two top spots on the 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2020. These two areas of focus for health plans, health systems, and providers – risk-bearing or otherwise – are also frequently referenced on the various lists of ‘Healthcare Predictions & Trends for 2020.’

Rising Costs & Increasing Patient Responsibility for Payment Drive Focus

In a presentation at this week’s 2019 WEDI Winter Conference, Dan Mendelson Founder of Avalere shared some eye-opening facts and statistics that underscore why “Cost & Transparency” is ranked as the top issue facing HCEG member organizations.

  • 84% of consumers believe drug prices are unreasonable
  • 2019 AHIP Consumer Experience & Digital Health Forum. Costs & Transparency. 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2020. health plans, health systems, providers. Healthcare Predictions & Trends for 2020. HCEG. HealthCare Executive Group.40% of Americans have saved enough to cover a $1,000 emergency
  • 57% of employees are offered a high deductible plan
  • $13K Average employee health benefit cost
  • Affordability is #1 issue for Democrats (45%) & Republicans (30%)

Higher premiums, higher deductibles, increasing co-insurance, and surprise medical billing are four trends that really took off about a decade ago and show no signs of slowing down. See more presentations from the 2019 WEDI Winter Conference here.

Strategies to Improve Transparency and Lower Costs

This time of year all the experts, thought leaders and prognosticators are making their predictions about 2020 and beyond. And Cost, Transparency, and Consumer Experience are frequently referenced items on those lists. The following are some of the more detailed predictions, strategies, and tactics to address the growth of medical and pharmaceutical costs and improve transparency and access.

  • Simplify explanation of benefits communications and simplify terminology
  • Provide members and patients with data that is understandable and usable in a secure and private manner
  • Making data available for review by independent 3rd parties
  • Merge clinical, financial, and operational data with CRM insights to enable greater transparency and enhance customer experience
  • Deploy and support ‘Local Market Relationship Liaisons
  • Develop a culture of transparency to more openly share information on the following:
    • Medical and pharmaceutical pricing
    • Payments and incentives offered to physicians for prescribing drugs
    • Results of clinical trials

All of the above demands the convergence of digital health technology with human needs and wants in a trust-based, member/patient-centered model supporting and balancing person-to-person engagement.

RELATED: “People Hate Shopping for Health Insurance”

Consumer Experience: Balancing Person-to-Person Engagement with Technology

Over the past five years, Consumer Experience has ranked in the #2 spot on HCEG’s Top 10 list four times. HCEG defines Consumer Experience as “Understanding, addressing and assuring that all consumer interactions and outcomes are easy, convenient, timely, streamlined, and cohesive so that health fits naturally into the ‘life flow’ of every individual’s, family’s and community’s daily activities.

As with ‘Costs & Transparency,” many of the lists of predictions and trends for 2020 and beyond include Consumer Experience as a prominently ranked item. The following are some ideas, strategies, and tactics healthcare organizations may consider to improve the healthcare consumer experience:2019 AHIP Consumer Experience & Digital Health Forum. Healthcare Consumer Experience. 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2020. health plans, health systems, providers. Healthcare Predictions & Trends for 2020. HCEG. HealthCare Executive Group.

  • Offer personalized mobile apps to leverage user-centric relevant notifications
  • Utilize blockchain technology to create a transparent and tamper-proof ledger of all member/patient transactions
  • Invest in member enrollment and patient recruitment programs
  • Service members and patients where they are outside the four walls of your office, hospital or practice
  • Chatbots for self-service and scaling member/patient interactions
  • Virtual reality providing an immersive experience for members and patients. A virtual tour of a health facility, demonstrating an example procedure and helping patients cope with pain are some examples

RELATED: Did CMS Just Declare 2021 ‘The Year of the Consumer?’

Offering a personal experience when it comes to healthcare is vital and today’s healthcare organizations must focus on utilizing digital health technologies to enhance and advance the experience of the healthcare consumer. Given the entry and disruption from non-traditional players like Amazon who’ve set the standard for consumer expectations, not doing so will surely result in extinction.

More on Costs, Transparency, and Healthcare Consumer Experience

Next week HCEG members and select sponsor partners will be presenting at the 2019 AHIP Consumer Experience & Digital Health Forum in Chicago. HCEG Executive Director Ferris Taylor and Ian Gordon, Former Sr VP & COO 2019 AHIP Consumer Experience & Digital Health Forum. Costs & Transparency. Healthcare Consumer Experience. 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives in 2020. health plans, health systems, providers. Healthcare Predictions & Trends for 2020. HCEG. HealthCare Executive Group.of Regence, will be presenting What Should Be Keeping Health Care Executives up at Night? They’ll share more ideas, strategies, and tactics healthcare organizations can use to improve the healthcare consumer experience. Learn more here.

HCEG member Sheri Johnson, AVP of Member Enrollment and Billing at UCare will present Creating Impactful Member Enrollment Correspondence on December 10th at 3:15 pm. Learn more here.

And Mark Nathan, CEO & Founder of HCEG sponsor partner Zipari, Inc. will present Revolutionizing Consumer Experience With a Single Platform Built for Health Insurance on December 10th at 4:10 pm. Learn more here.

Join senior healthcare leaders and line-of-business executives and leave Chicago with guidance for managing the implications that reducing costs, improving transparency, and enhancing consumer experience portends for your IT investment priorities and implementation strategies.