Value-based Payment (and Value-based Care Reform) has ranked among HCEG’s Top 10 list of challenges, issues, and opportunities each of the last 10 years that HCEG’s Top 10 list has been published; a clear indication healthcare leaders realize that the move to payment for outcomes (value) vs. volume (FFS) is inevitable. It’s clear that value-based relationships & reimbursement is important to health plans, health systems and provider organizations. But year after year, shared-risk, value-based healthcare appears to be just around the corner. Why so slow? How can healthcare leaders championing the transformation of America’s healthcare system finally begin to realize the value of value-based payment?
In fact, the majority of respondents to the 2019 Industry Pulse Research Survey indicate that value-based relationships including both upside and downside shared risk still appears to be three to five years off.
If what’s apparently widely thought, then why is the move by health plans, health systems, and healthcare providers to value-based reimbursement perpetually stuck at being three to five years away from adopting shared-risk value-based contracts?
Speeding the Move to Value-Based Relationships & Reimbursement
On Wednesday, September 11th, the HealthCare Executive Group is presenting a special Executive Leadership Roundtable as part of their 31st Annual Forum. This interactive roundtable event open to everyone who’s in Boston on September 11th – there’s no charge to join other healthcare leaders from across the country to learn about value-based care and meet others facing similar challenges. To be clear, this special ELR event is open to everyone.
Participants of this special ELR will benefit from:
Interactive discussion between attendees and speakers on what the movement to value means
Learning about the top challenges and opportunities in transitioning from payment for volume
Why healthcare organizations are hesitant to provide value-based care and thoughts on overcoming them
Understanding realistic next steps healthcare leaders can take to make real progress in the move to value
Recent successes in new payment models and lessons-learned
A look at cross-industry partnerships in the movement to value-based care reimbursement
This will be a rare opportunity for Healthcare Champions who gather in Boston on September 11th to learn more about value-based payment and care opportunities and to interact with speakers and other participants on a meaningful basis.
The $64,000 Question (Or the $64B+ Question?) – Always 3 to 5 Years Away
Why is the move by health plans, health systems, and healthcare providers to value-based reimbursement perpetually stuck at being three to five years away from adopting shared-risk value-based contracts?
To learn how to advance value-based care, join us at the Hotel Commonwealth for our September Executive Leadership Roundtable event -Value-Based Relationships & Reimbursement: How can Industry Collaborate to Speed the Move to Value? -and learn from the following session leaders and ELR participants:
Panelists Sharing Insight on Value-Based Relationships & Reimbursement
The 31st Annual Forum of the HealthCare Executive Group begins on Monday, September 9th – long considered a hotbed of healthcare and digital innovation. Champions focusing on the healthcare and digital innovation necessary to transform the healthcare system in the United States will be gathering at the Hotel Commonwealth in Boston, Massachusetts at our 31st Annual Forum. They’ll interact with their healthcare peers, learn more about how others are addressing similar challenges, issues, and opportunities, and create new relationships to advance their company-focused and personal missions.
In previous posts, we’ve shared the following details on how this year’s Annual Forum provides meaningful value to the leaders transforming their healthcare organization:
Enjoy lunch while meeting fellow forum attendees and enjoying a compelling, fun, and interactive Quizzify orchestrated by Al Lewis, Quizzify President. Learn just how much you do not know about healthy behavior.
The DC Landscape: Policy Poised to Impact Health Plans in the Near Term
Matt Eyles, President and CEO of AHIP, helps forum attendees understand which conversations in DC are most essential as they form their business strategies for future years.
Changing the Story: The Myths and Missed Opportunities for Connected Care
Ann Mond-Johnson of the American Telehealth Association shares insight on the barriers to broader adoption and future opportunities to take advantage of connected care technologies in improving care and reducing inefficiencies across the health care system.
Knowledge is Power: Cost Transparency as a Shared Strength and Responsibility
In this breakfast keynote address: panelists Niall Brennan, President & CEO of the Health Care Cost Institute and Dr. Michael Sherman, SVP & Chief Medical Officer of the Harvard Pilgrim Health Care and Lecturer at Harvard Medical School share how health plans may collaborate to enable best-in-class data sets and provide greater value to both the business and member through transparency.
Logistics & Transportation Panel Discussion: Promote Health Equity and Remove Transportation as a Barrier to Care
Megan Callahan, Vice President of Healthcare at Lyft and other panelists examine the role of transportation in ensuring access to critical health services, with an emphasis on improving care and experience for under-served Medicaid and Medicare populations.
Digital Transformation: How Novel Technologies are Making a Tangible Impact
In this panel discussion, Mariya Filipova, VP of Innovation at Anthem, Ray Constantini, MD, CEO and Co-Founder of Bright.MD and Oron Afek, CEO and Co-Founder of VIM discuss use cases for disruptive innovation in digital health including short- and long-term impacts on their business, relationships with other stakeholders, members, and patients.
Beyond the Trend: Follow the Money to Identify Technologies Defining the Future of Healthcare
Panelists Ricardo Johnson of Healthworx at CareFirst Blue Cross Blue Shield, Ryan Stewart, Managing Director of Healthcare Technology Investment Banking at Leerink Partners, and Tuoyo Louis, Founder and Managing Partner of Bambu Global Healthcare Advisors discuss the current M & A landscape with a focus on technology investment. Gain insight into which advancements investors are betting on and why.
2020 HCEG Top 10 & Industry Pulse Roundtables: Voting and Ranking
HCEG board, HCEG members, sponsor partners, and forum participants interact with each other to identify the 2020 Top 10 challenges, issues and opportunities for their organizations. Join your peers and be part of shaping the 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leaders during these continued uncertain times.
Unleash Value and Innovation in Your Organization: Understanding the Problem You Don’t See
Jason Woo, MD, MPH, FACOG, Medical Officer at U.S. Public Health Service helps forum participants identify the foundational challenges healthcare organizations we often fail to see that inhibits their own success.
Develop a Collaborative Approach to Address the Opioid Crisis
Gregory Marotta, CEO of Clean Slate Opioid Clinics and Dave Henderson, CEO of Thrivee explore how organizations are today in dealing with the opioid epidemic and collaborative strategies to move forward.
Sustaining Outcomes and Savings through Lifestyle & Behavioral Modification
Eric Hamborg, co-founder and chief commercial officer at MOBE will be joined by other prominent panelists. They’ll discuss how services with sustainable cost-saving models can be designed and delivered to address the challenges of a growing hidden population of members with complex health profiles.
Closing Keynote: Massachusetts Healthcare and Political Landscape
A well-known thought leader from New England on the leading edge – sometimes the bleeding edge – of healthcare reform and transformation will close out the second day of our Annual Forum. Their presentation centers around what has happened and might happen in the future with New England healthcare – a vanguard of healthcare transformation in the United States.
Wednesday, September 11, 2019
Special Executive Leadership Roundtable at Our Annual Forum
A special Executive Leadership Roundtable event – Value-based Relationships and Reimbursement: Why is the Transformation Taking So Long? – is open to everyone!
Value-Based Relationships and Reimbursement: Why is the Transformation Taking So Long?
Jeff Micklos, Executive Director of Health Care Transformation Task Force (HCTTF) and colleague Clare Pierce-Wrobel will be joined by HCEG sponsor partners Harry Merkin of HealthEdge and Mayer Yermaneni of EQHealth.
They’ll share insight on how payments to physicians and other practitioners are not patient-centered nor value-based. And how our healthcare industry is still primarily “fee-centered” with few providers incentivized to provide value-based care. Register for this special Executive Leadership Roundtable event taking place on Friday, September 11th here.Note: This ELR event is open to everyone and registration at the 2019 HCEG Annual Forum is not required.
Healthcare Leaders Sharing in a Trusted Environment
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 uncommon speakers identified above, we’ve got some additional sessions and uncommon healthcare conference surprises in store. Contact Juliana Ruiz if you require any assistance.
The HealthCare Executive Group is built around two core values: that healthcare leaders trust their peers more than any other source when facing industry challenges; and that, because those challenges evolve every year and impact similar organizations in different ways, meaningful interaction between industry leaders must be supported by the environment, agenda, and background of speakers and others presenting their knowledge, experiences, and ideas.
For over 30 years, the Annual Forum of the HealthCare Executive Group has endeavored to pursue these core values in our events, content and other support for our members and the healthcare industry at large. In the month’s leading up to HCEG’s Annual Forum, a team of trusted healthcare executives supported by event planning professionals gets to work. The agenda is developed based on the current HCEG Top 10 list. Qualified leaders in the healthcare industry leaders are identified and engaged. A supportive venue, fare fitting a queen and special networking events are contracted. The result is an event supporting the exchange of timely, useful information exchange and open dialogue and interaction between speakers and attendees.
Diverse Mix of Healthcare Industry Knowledge
While originally comprised of leadership from mid-market health plans, the HealthCare Executive Group has evolved over the years to include senior leaders from national healthcare associations, health systems, provider organizations, public health servants, research organizations, and more recently, leaders of organizations that partner to share risk. Given the uncertain and rapidly changing healthcare environment, it’s important that Annual Forum speakers represent a diverse mix of perspectives on how to improve healthcare outcomes and lower costs. And the disruption of traditional roles by new market entrants and the creative partnerships being made demand a new mix to insight shared.
For the 2019 Annual Forum, the following individuals have been confirmed to be sharing their knowledge, insight, and opinions with forum participants. Another dozen individuals are pending formal agreements.
Matt Eyles, President & CEO, America’s Health Insurance Plans (AHIP)
Ann Mond-Johnson, CEO, American Telemedicine Association (ATA)
Charles Stellar, President & CEO, Workgroup for Electronic Data Interchange (WEDI)
Mariya Filipova, Vice President of Innovation, Anthem Inc.
Gregory LeGrow, Sr Director Technology Engagement Solutions, BCBS of MA
Megan Callahan, Vice President of Healthcare, Lyft
Healthcare Leaders Sharing in a Trusted Environment
Perhaps the most unique aspect of HCEG’s Annual Forum – and our Executive Leadership Roundtable events – is the manageable number of attendees, the supportive, intimate environment and the lack of vendor and media participation that too many other healthcare conferences entail. Our goal is to foster the level of trust necessary for attendees to feel comfortable about their participation. To share difficult experiences and inside tips, as well as to pose questions participants might not otherwise feel comfortable asking in the more populated, public setting of most healthcare conferences.
We believe that the agenda and setting of our events attract the best and brightest leaders in healthcare – both speakers AND attendees.
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 uncommon speakers identified above, we’ve got some additional sessions and uncommon healthcare conference surprises in store. Contact Juliana Ruiz if you require any assistance.
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.Participants 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.
President, Commercial & Consumer Markets at Independence Blue Cross
Managing Director, Healthcare Payments at JPMorgan Chase & Co
HCEG 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:
Insight into how healthcare organization can enhance member/patient engagement
How competition from new entrants, cost containment pressures associated with value-based programs, health/entitlement reforms, and technological innovations may impact ‘healthcare consumerism’
Approaches for turning passive health plan members and health system patients into active healthcare consumers
Catalysts for healthcare consumerism change: employer groups demanding better value and trend of health plan members and individuals directly engaging with plans and providers
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.If 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.
In celebration of our 30th Anniversary and the 2018 Labor Day holiday, the HealthCare Executive Group (HCEG) is offering a discounted rate on a special 2-hour breakfast roundtable event presented by Dan Buettner on Friday, September 14th
Add Purpose, Pride, and Pleasure to Create Joy in Your Life
Starting at 7:30 am at the Hewing Hotel, attendees will enjoy a full breakfast as Dan Buettner, NY Times Best-Selling author and National Geographic Fellow presents: “The Blue Zones of Happiness: ‘Lessons from the World’s Happiest People.’”
Dan will share his latest insight on the three strands of happiness: purpose, pride, and pleasure. Attendees will discover the many factors to bring joy to their lives as Dan shares important lessons learned about how the choices we make and the environment in which we live contribute to our happiness.
Network with Healthcare Leaders & Enjoy Breakfast
This event takes place on the final day of HCEG’s 2018 Annual Forum. Besides the presentation and full breakfast, attendees will enjoy opportunities to network with healthcare leaders participating in HCEG’s annual forum over the previous two days. Those wanting to attend can register here using discount code HCEGLaborDay to receive $20 off the $65 registration fee. Please contact Erin Branham at [email protected] if you need assistance with registering.
Registration for HCEG’s 2018 Annual Forum Closes Soon
The 2018 HCEG Annual Forum celebrating the HealthCare Executive Group’s 30th Anniversary closes on Saturday, September 8th. We have a unique agenda, prominent keynote speakers, insightful panelists, and a number of networking events planned; all in a supportive and intimate setting.
For more information on this unique event for healthcare executives, thought leaders and industry participants – including registration – click here.
The HealthCare Executive Group (HCEG) was honored to co-host a special Executive Leadership Roundtable May 9th at the recent HLTH Future of Healthcare Forum. HCEG partnered with the International Association of Innovation Professionals (IAOIP), the Center for Healthcare Innovation (CHI), the Workgroup for Electronic Data Interchange (WEDI) and special guest Dr. Sunnie Giles for the Boardroom-style event. The theme of the roundtable was Leadership, Trust and Skills in Overcoming Obstacles to Radical Innovation in Healthcare. Over a period of 3 hours, Charles Stellar, CEO of WEDI, moderated a panel of innovation and healthcare thought leaders as each shared their respective insight on the following topics:
Ferris Taylor, HCEG Executive Director, shared insights on innovation and technology gleaned from the HCEG member organizations, the HCEG Top 10 and 8th Annual Industry Pulse Survey
Brett Trusko, CEO of IAOIP, shared an International overview of Innovation Certification programs
Lynn Hanessian, Chief Strategist, Edelman Health representing CHI, shared info and highlights from the Edelmen Trust Barometer research, and
Dr. Sunnie Giles shared key findings from her research and recent book supporting “The New Science of Radical Innovation”
Insight into Obstacles to Radical Innovation in Healthcare
After each panelist concluded their presentations and key takeaways, an open Q & A period between panelists and attendees took place. This discussion evolved into an intimate engagement among Executive Leadership Roundtable attendees ensuing into a free-flowing, rather ‘un-conference-like’ approach. Interaction was so engaging that many session participants hung around AFTER the official end of the Executive Leadership roundtable to continue the discussion, network with each other and build professional relationships that are destined to accelerate more considerations in the future.
Insights on Radical Innovation in Healthcare – The HCEG Top 10 and 8th Annual Industry Pulse Research
Ferris Taylor connected the development of the annual issues to the common theme of innovation and technology and then shared five highlights of the 8th Annual Industry Pulse report – a survey of 2000 healthcare stakeholders jointly conducted by HCEG and its sponsor partner, Change Healthcare.
Social determinants of health have now transcended buzzword status
High-deductible health plans are not converting passive patients into active healthcare consumers
Mobile/digital health adoption is not just about functionality and interoperability, but is significantly impacted by privacy and security concerns – more about trust than technology
Industry attention is turning to blockchain, artificial intelligence, robotic process automation and other advanced technologies
Healthcare is transitioning from negative to positive incentives to influence consumer behavior faster than most expect
The Edelmen Trust Barometer
After Ferris Taylor set the context for key areas of need and innovation in healthcare, Lynn Hanessian shared a detailed overview of the Edelman Trust Barometer – a measure of people’s trust in business, government, NGOs and media. Lynn opened with a sobering chart showing a historical decline in trust over the period of 2017 to 2018 – with 14 of 15 sectors showing an overall decrease in trust.
Lynn also shared insight from the Edelman report showing the division of opinion as to the impact of Tech to the Cost of Healthcare: 23% of respondents believed that technology will make healthcare MORE expensive over the next 5 years and 16% believe technology will make healthcare LESS expensive.
Overview of International Innovation Certification Programs
Brett Trusko of the IAOIP shared an overview of how the IAOIP is on a mission to professionalize the practice of innovation around the world. Brett shared the following methods that the IAOPI believes will be critical to promote the IAOIP’s mission of advancing innovation:
Brett also shared an overview of the Current Body of Best Practices for Innovation, why ‘professionalization’ of innovation is important, his beliefs as to why Failure to Innovate is NOT an Option, He closed his presentation with What You Can Do Now to advance the professionalization of innovation.
The New Science of Radical innovation
Dr. Sunnie Giles rounded out the initial roundtable presentations by sharing some highlights from her new book “The New Science of Radical Innovation.” Sunnie shared:
A Definition of Radical Innovation
The Concept of VUCA (especially in healthcare): Volatility, Uncertainty, Complexity & Ambiguity
4 Factors That Make Radical Innovation Challenging for Leaders
How to Harness Volatility, Uncertainty, Complexity & Ambiguity to Increase Innovation in Healthcare
Open Discussion About Innovation at HLTH Future of Healthcare Forum
All in all, the Executive Leadership Roundtable at HLTH was an informative and engaging event. Of the 120+ registrants, over half participated in the roundtable with a number of walk-ins and with many of those individuals remaining afterwards to continue the discussion about the opportunities and challenges for innovation in healthcare. Given that the HLTH Association Day was the afternoon of the last day of the 4-day HLTH forum, all participants and presenters considered it a great success!
HCEG appreciates the collaboration with Brett Trusko from the Association of Innovation Professionals, Lynn Hanessian representing the Center for Healthcare Innovation and Dr. Sunnie Giles of the Quantum Leadership Group. HCEG would also like to extend a special thanks to Charles Stellar of WEDI for moderating the panel and representing WEDI’s role in innovation and technology so well.
Connect with Each Other and The HealthCare Executive Group
If you enjoyed the 2018 HLTH Future of Healthcare Forum, or would like to participated in a greatly scaled down yet equally valuable version of the forum, consider being part of the HealthCare Executive Group’s Annual Forum taking place in Minneapolis, MN on September 12 – 14th. We have a special event planned to celebrate our 30th year anniversary. Moreover, if you’re a healthcare executive who can benefit from collaborating with your C-suite peers, consider becoming a HCEG member.
The 29th Annual Forum of the Healthcare Executive Group held in Nashville last week included nine sessions lead by healthcare industry leaders. These industry veterans and thought leading panel members provided forum participants with a wealth of information and insight into key areas of healthcare reform, innovation and digital transformation. As might be expected, insight, ideas, opinions and concerns surrounding the areas of Consumer Engagement, Transparency, Population Health, Health Plan-Provider Data Exchange, and Merger & Acquisition activity within the digital healthcare space were common across nearly each of the nine sessions presented at the forum.
As noted in this previous post, content from these sessions will be shared over the coming days and weeks. In this post, highlights from each of the above referenced areas shared by forum participants via social media are presented. Special thanks to all those who shared via their social channels. To receive other information shared during our 2017 Annual Forum, consider subscribing to our newsletterand following us on our social channels: Twitter, LinkedIn and Facebook.
“Need time to develop trust w/ others; it typically takes 30 days of near daily engagement.” – Rich Rakowski of Medically Home
“Coins term ‘Co-vider’ where healthcare consumer serves as 1st provider identifying (diagnosing?) medical condition.” – Steve Sisko @ShimCode quoting David Vinson of @DHXGroup
“We’re trying to put the pharmacist in front of the counter – to more easily interact with consumers.” – William Resnick of EmpiRx Health
“Many health plans have lost sight that they’re essentially a community of people that must be regularly engaged.” – Torben Nielsen @TorbenSNielsen of Premera
“Near unanimous consensus by participants that technology is not the problem; rather policy, inertia & politics.” – Steve Sisko
“What’s your one ‘dashboardable metric?” Rich Rakowski: “A 30-50% savings for the payer for patient condition.” – Ben Leedle of Blue Zones, LLC asking “What was Missed in Two Decades of Population Health – Today’s Opportunities for Disruptive Innovation” panel
“Cognitive behavioral therapy is becoming first line treatment for insomnia; not drugs.” – Joe Jennings, CEO at BeHealth Solutions @behealthsolns
Social Determinants of Health
“Katrina lesson: sensitive extreme collaboration. Social determinants become real.” – Chuck Martel @cmartel on Dr. Karen DeSalvo keynote
“Our zip code affects our health more than our genetic code.” – Richard Lungen @rlungen of @Leverage_Health quoting Dr. Karen DeSalvo
“Healthcare spend and trend is crowding out other essential social investments. Agree?” – Mark Stryker on Dr. Karen DeSalvo keynote
Accountable Care Organizations
“First step to ACO success: providers and payers agree to ‘put down their weapons’ with data.” – Chuck Martel quoting John Poelman @JHPoelman of Leavitt Partners @leavittpartners
“Panelists note there is no clear correlation between #ACO financial results and quality measurement outcomes.” – Steve Sisko quoting panelist in “Value-Based Reimbursement/Relationships” session
“Data is the single most important element we’re just beginning to exploit.” – Chuck Martel quoting Torben Nielsen in “Healthcare & Consumers Going Digital – Is HIT a Disruption or Opportunity?” session
“The unabated proliferation of healthcare apps is “Appageddon.’” – Steve Sisko quoting David Vinson
“I work in healthcare during the day. And then I go home to the 21st century.” – Torben Nielsen
“Technology and Technology companies’ are re-creating what health looks like.” – Mark Stryker paraphrasing Dr. Karen DeSalvo keynote
Transparency of Price & Quality
“Need to differentiate between price transparency & transparency of clinical efficacy & potential interactions.” – Blake Slansky of Walgreens
“Are we going to try to compete w/ Amazon on cost? Or quality of service? How will we protect our position?” – Forum Attendee asks panel addressing “Pharmacy Costs / PBM and Rx Transparency”
“Only two countries allow Direct to Consumer marketing of prescription drugs: United States & New Zealand.” – Nichole (Nikki) White of Medica
Mergers & Acquisitions in Healthcare
“What are some of the things that are going well or not so well in healthcare M&A?” – Justin Roth of Triple Tree Investments @TripleTreeLLC asks “Technology Innovation and M&A Market Trends” panel
“Need to move cultural due diligence upstream in the M&A process.” – Tom McEnery of Change Healthcare @Change_HC
“Having a designated liaison for each functional area. And be sensitive to culture of each area.” – Paul Wallace of Heritage Group USA
Plan Provider Data Mgmt
“Providers view data updates as a misplaced burden & something that disrupts patient care.” – Charlie Falcone of Aperture Credentialing during “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panel
“The proliferation of networks – especially ACO’s – has exacerbated provider directory data accuracy issues.” – Ian Gordon of Regence/Cambia Health Solutions @Cambia
“Working w/ data originators to co-develop data exchange processes vs. dictating requirements can improve data.” – Ian Gordon
“Differing state regulations & mandates hamper ability to develop shared plan-provider data mgmt processes.” – Steve Sisko paraphrases Charlie Falcone
“Provider data management is not a strategic act but an ongoing tactical & operational activity.” – Russ Thomas of @Availity
“Plan-provider data management is not a technology problem; it’s an engagement challenge.” – Ian Gordon
“Health plans generally don’t view provider data management as an area where they need to compete.” – Russ Thomas
“Panel members all agree that #ACA should have mandated plan-provider data requirements, standards & update processes.” – Steve Sisko paraphrases “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panelists
“Fail to succeed…glean something from every mishap and mistake.” – Donato Tramuto (Via @Tivityhealth)
“Core competencies are transferrable. Don’t confuse what people do with what they are good at.” -Tom McEnery
There’s More Coming!
We’re just getting started with sharing content from last week’s 29th Annual Forum of the Healthcare Executive Group. We’ll be sharing recaps from individual sessions, participant interviews, pictures from the forum and more. So stay connected and in the loop bysubscribing to our newsletterand following us on our social channels. Better yet, consider becoming a membertoday!
Our 2017 Annual Forum came to a close at noon this past Wednesday. Over 110 healthcare executives, nationally known healthcare speakers and industry thought leaders gathered in Nashville, TN – Music City and the Healthcare Capital of the United States – to share their insight, ideas and concerns about healthcare reform and digital transformation during these rapidly evolving, uncertain times in healthcare.
The 29th Annual Forum featured three keynote speakers, nine sessions covering the latest topics of interest to executives leading health plans and health systems and three nighttime events structured to support networking between forum participants. All in all, the two and half days of our 2017 Annual Forum added up to one incredible opportunity for those leading the digital transformation of healthcare reform in the United States to come together on an intimate basis , to share and learn with each other collaboratively.
The 2018 HCEG Top 10 List
As has taken place during each of the last seven HCEG Annual Forum events, participants selected and voted on the Top 10 Opportunities, Challenges and Issues facing health plan and health system executives over the coming months and year. This new 2018 HCEG Top 10 list will drive the focus of Executive Leadership Round Tables, webinars, content development and other collaborative opportunities throughout the remainder of 2017 and the coming new year.
What We’ll Be Sharing From Our 2017 Annual Forum
Over the next few weeks, insight, ideas, opinions and concerns generated during the forum will be shared with members and the public at large. We’ll recap forum speaker and participant insight and opinion into how healthcare in the United States will be impacted by healthcare policy reform, digital transformation initiatives and both national and state-level actions. Readers of this blog, our friends on social media, attendees of our webinars and round tables and subscribers to our newsletter can look forward to how speakers, panelists and participants at our 2017 Annual Forum shared insight on the following:
How Clinical and Data Analytics leverage clinical evidence to segment populations, manage health and drive decisions
How the emergence of Population Health Services Organizations are operationalizing population health strategy, chronic care management, driving clinical integration, and integrating social determinants of health
How Value-Based Payments are being used to target specific medical conditions to manage cost and quality of care
How Cost Transparency is inevitable due to growing legislation and consumer demand
And more certain topics that can help healthcare leaders address transformation during these uncertain healthcare times
How We’ll Share
The Healthcare Executive Group will share the following via its web site, blog, social channels – including Twitter, LinkedIn an Facebook, and via other channels including member LinkedIn accounts, sponsor partner media and healthcare industry media. Look for the following:
Quotes from Keynote Speakers & Panelists
Session recaps including Presentation Materials
Thoughts from Forum Participants including social media shares
To be sure, the Healthcare Executive Group (HCEG) isn’t on the same plane as these healthcare research firms listed above. The Healthcare Executive Group doesn’t have sales people balancing objective analysis with the need to generate revenue to keep the doors open. HCEG is a relatively small (by design), membership-based organization of mid-market healthcare executives in a national network who gather together physically and virtually throughout the year to learn from each other as they navigate the strategic and tactical issues facing they face as health plan and health system leaders. The concept is really quite simple and powerful:
HCEG’s mission is to promote healthcare innovation, to provide innovative knowledge support and to help sustain the development of life-long relationships through real-life and virtual relationships.
For almost 30 years, the Healthcare Executive Group has served as a channel for the open exchange of ideas, providing content, channels and opportunities for collaboration, and ongoing support for transformational dialogue among its members. The HCEG Top 10 List helps focus and drive this content development, member dialogue and knowledge exchange.
What’s the HCEG Top 10 List?
While each HCEG member and the healthcare organizations they represent are unique, all face common opportunities, issues and challenges. Technology, healthcare reform initiatives and innovation opportunities are moving quickly. The longevity of our member companies and our members own livelihood depends on their ability to identify and sufficiently address opportunities, issues and challenges; as they are presented; and as quickly as possible.
The HCEG Top 10 represents the top 10 opportunities, issues and challenges that HCEG members – health plan and health system executives at the forefront of healthcare reform – collectively identify as the most important and urgent to address over the following year. Our members consider the Top 10 items as having significant and lasting impact in the way health plan members, healthcare consumers and patients all become engaged, digital consumers and responsible healthcare stakeholders.
How is the HCEG Top 10 List Developed?
About two months in advance of HCEG’s Annual Forum, an initial list of approximately 25-30 opportunities, challenges and issues are identified by HCEG members via a survey process.
Then a set of questions intended to refine and clarify each of the 25 – 30 items are defined. These questions are intended to help members better understand each item and encourage well-measured responses. To the greatest degree possible, the questions for each topic are designed to elicit discrete, standardized responses; common industry terminology and pick lists of potential responses are used wherever possible.
These topics and their supporting questions are then entered into a survey tool and shared with all HCEG members. At the HCEG Annual Forum, members review and discuss each topic and associated questions. A series of rankings take place to winnow the list down to the Top 10 items. Members have the opportunity to question each item, each other and to rank each item publically or privately. At the end of the second day of the Annual Forum, the new Top 10 List is formally defined and shared with all forum participants and other HCEG members who may not be in attendance at the Annual Forum.
How is the HCEG Top 10 List used?
The HCEG Top 10 List is used for two general purposes, each of which are intended to address the so-called Triple Aim of Healthcare.
1. Content Development & Programming
The HCEG Top 10 list serves as the basis for HCEG’s ongoing content development and educational programming opportunities throughout the year. Each of the Top 10 items is explored at various levels of depth and breadth throughout the year and delivered to HCEG members via various mechanisms and channels including:
In addition to guiding the overall thought-leadership, content development, and knowledge exchange initiatives throughout the year, HCEG’s Top 10 Priorities, Issues & Challenges list serves as the basis for The Industry Pulse– a national, industry-wide survey where healthcare leaders across the nation are invited to participate in additional research to backdrop and contrast their perspectives against the items on the Top 10 list.
The Industry Pulse research survey is designed to gather additional insight on priorities and challenges facing healthcare industry constituents across the country and provide stakeholders across the healthcare spectrum real-world, actionable insight into near term obstacles and opportunities. Combined, the HCEG Top 10 list and The Industry Pulse encourage continuous and evolving dialog on the main issues and concerns facing member organizations.
The 2018 HCEG Top 10 List
Our 2017 Annual Forum will be held on September 18 – 20th in Nashville, TN at the Thompson Hotel and the 2018 HCEG Top 10 list will be developed during this three day forum. Developing the latest HCEG Top 10 List is an exciting part of our Annual Forum and we expect lively and thought-provoking discussion experienced in previous forums.
For more information on the Annual Forum including how to register and be a part of defining the 2018 HCEG Top 10 List, see this page.
Our Executive Leadership Forum held at the GuideWell Innovation Center on Monday, May 8th was attended by 21 healthcare executives and solution provider thought leaders. The three-hour event – titled Operationalizing Before Analyzing: Healthcare’s Modern Journey Powered by Data – focused on some of the underlying challenges and issues regarding how healthcare data and analytics technologies impact consumers, providers and health plans.
The forum included lively discussion on real world use cases for healthcare data and analytics, a demonstration of live 3D interaction possibilities and a tour of the GuideWell Innovation Center. The forum was capped off by a happy hour for participants to network with each other and forum sponsors: MarkLogic and Intel.
In this post, highlights of the discussion between forum participants and key takeaways will be presented. In future posts, an overview of the 3D interaction demo and tour of the GuideWell Innovation Center will be shared.
HCEG Board Chair Ferris Taylor shared some information on the tour of the GuideWell Innovation Center and Live 3D Collaboration in this post on LinkedIn.
Demand for Real-time Data and Transactions
A lot discussion during the forum centered around current complexities and how demand for real-time data and transactions—across clinical, administrative and financial operations–is increasing exponentially every day and putting significant demands on service model / operations and legacy infrastructure, which are mostly batch / file transfer oriented. Several issues were identified as current concerns:
Many underlying data challenges
Lack of agility in quickly responding to opportunities
Inadequate data governance/provenance with ETL approaches in the legacy data pipeline
All audience members agreed they wanted faster time to market and better ability to respond to clients / market / regulations and be more agile when it comes to data. There was broad agreement that “data integration” is a journey that should follow a new data integration pathway instead of the legacy Extract-Transform-Load (ETL) approach:
Real World Use Cases
Over the course of the discussion there were a number of data capture and analytics use cases shared between forum participants. One use case described enrollment data submitted to the IRS on the 1095-B Health Coverage forms sent to individuals noting their qualified health coverage during each month in the year.
One participant described how the IRS had reported back to the health plan that 40% of the records submitted by the health plan to the IRS had errors in name, social security number and/or dependent status; basic required enrollment data elements that the plan was not able to validate or authenticate during the initial enrollment process and remained that way throughout the entire year. Garbage-In-Garbage-Out.
This “1095-B use case” elicited feedback from one forum participant having recent experience at the Census Bureau with the participant describing how government agencies often don’t have complete, accurate data. Just because CMS might have data of one quality level, they don’t always share that data with related agencies so the IRS or the SSA or state Medicaid administrators likely have different data.
Leverage All Data Types & 3rd Parties
Forum participants shared unique perspectives and a Q&A ensued on the example of how the Census Bureau uses associated data to significantly improve the timelines, accuracy and overall value of census data by editing it against 3rd party sources. This Census Bureau use case and another use case described by forum participants of a BCBS plan emphasized that 3rd party data sources and unstructured data are very important to service improvement, member/patient experience, innovation and growth-oriented project investments.
Primary Investment Areas: Data Improvement & Integration Projects
Forum members identified the following investment areas for data improvement and integration projects that healthcare executives may implement over the next 12-18 months to modernize healthcare data and applications:
Thought Leader Presentations
This Executive Leadership Forum was co-sponsored by MarkLogic and Intel. The information shared by these two sponsors are made available here:
At the end of the forum, participants unanimously agree on three basic tenets:
Complete and accurate data – especially basic demographic and social determinants – MUST begin with the first member/consumer/patient-provider interactions at the point of service
Data needs to be authenticated, validated, verified and ENRICHED against other sources – then normalized across other supportive partners and their ‘systems of record’
Today’s technology can support the capture, validation and use of healthcare data on a relatively inexpensive basis.
Join Other Healthcare Leaders
For more information on the Healthcare Executive Group and how you can become more ‘in the know’ and effective as a healthcare executive or thought leader, check out this information about becoming a member. You can also follow us on Twitter, friend us on FaceBook and follow us on LinkedIn.