The 10th Annual Industry Pulse research survey opens today!
And healthcare industry leaders are encouraged to share their take on the challenges, issues, and opportunities they’re facing in 2020 and beyond. Based on the 2020 HCEG Top 10 list and conducted jointly by the HealthCare Executive Group and Change Healthcare, the survey is intended to flesh out and explore what leaders of healthcare organizations may be facing in the immediate future. Everyone reading this post are encouraged to complete the survey and share it with their co-workers and associates. Just taking this survey will provide respondents with thought-provoking questions and offer ideas they may otherwise not be aware of.
2020 HCEG Top 10 as Basis for 10th Annual Industry Pulse Survey
This 10th annual instance of the Industry Pulse collects additional insight, experiences, and opinions on specific items of the 2020 HCEG Top 10 list developed in September 2019 at HCEG’s 31st Annual Forum. The questions, possible responses, and results of the Industry Pulse can provide valuable, relevant data-driven advice and end-to-end industry insights to help healthcare leaders navigate the complexities of our rapidly evolving healthcare system.
Share your Insight Today!
HCEG and Change Healthcare would like to invite healthcare leaders from across the nation to participate in this year’s Industry Pulse research survey and to compare and contrast their own perspectives against the 2020 HCEG Top 10.Please consider sharing your insight, experiences, and opinion as your perspective will help define the issues facing healthcare, and reveal how the industry is responding. Everyone who completes the 10th Annual Industry Pulse Survey will be among the first to receive survey results as well as exclusive access to future webinars, content, and events that will be delivered over the new year; expounding on survey results and providing additional insight and value to all healthcare constituents.
We’re in the middle of a crisis, not only as healthcare leaders transforming our healthcare system but also as Americans. The opioid substance use crisis in America is real and if it’s not already there, it’s coming to your neighborhood – or immediate and extended family soon. How can you help? What small thing might you do?
The First Step to Help Solve Substance Use Crisis
The first step in helping to solve this crisis is acknowledging that it’s not an affliction of the seedy underbelly of our society. Rather it’s a demon that knows nor respects any boundaries. Being afflicted by substance use challenges is rarely, if ever, a choice. It happens to people just like you and me who may have been prescribed opioids after surgery, or to address chronic pain or other ailments.
Nobody grows up with aspirations of becoming addicted to opioids!
Bringing People Together to Address Substance Use Crisis
Left: David Henderson (Kaden Health) and Gregory Marotta (CleanSlate Centers, Inc)
The second step is doing something more than just admitting the problem. At HCEG, we bring people together to talk about the issues facing healthcare organizations and professionals. But more than just talking about the problems, we discuss and debate solutions, encourage participants to take action and strive to support those actions.
At our recent 31st annual forum in Boston, we heard firsthand from two industry leaders who are doing much more than talking about our substance use crisis. David Henderson, CEO of Kaden Health (formerly Thrivee) and Gregory Marotta, President and CEO of CleanSlate Centers, Inc. shared the different but complementary approaches their companies are taking to help people with substance use problems. As the audience engaged in the conversation with our panel, we heard from real people about their personal experiences with substance use challenges and discussed how to breakdown the “not in my family or neighborhood” attitude.
Take a Small Step Today!
The panel was closed with a challenge to each forum participant to write down and share one action they personally or their organization could – and more importantly would – take to be part of the solution. The energy and conversation following our Substance Use panel were intense and the forum’s consensus was that it would be a crime for us to let it die.
Today, HCEG board members are challenging each and every person who reads this blog post to commit to one action to help address the substance use crisis in America and to share that commitment with us. Please share your commitment to making a difference via any of the following public or private channels. We’ll respect everyone’s privacy and not publish any names or personal information unless informed otherwise.
Our goal is to collect all of your commitments and track the progress and the difference that we as individuals – many almost certainly directly or indirectly impacted by the opioid crisis – are making. We’ll assemble, acknowledge and share those ideas via our upcoming in-person events and virtual channels. Little things do add up to BIG THINGS!
Alone we can make a dent…Together we can make a difference!
Since the late 1990’s, the reimbursement landscape in healthcare has been changing. Capitation models paved the way for a change from traditional fee-for-service (FFS) payment models to a focus on helping physician partners establish effective, cost-efficient practice models. And now value-based payments are the latest and greatest models for reimbursement of care. In fact, value-based payments were ranked by HealthCare Executive Group members as #3 on the 2018 HCEG Top 10 list.
While uncertainty surrounding healthcare reform in the United States continues and the industry waits for more definitive reimbursement policy from the federal government, one thing is certain—the trend for value-based payments (VBP) continues. Health plans and providers really have no choice but to transition from the traditional fee-for-service model in order to drive down soaring costs and positively impact patient outcomes.
“There is no turning back to an unsustainable system that pays for procedures rather than value” and the transition “needs to accelerate dramatically.”
– Alex Azar, Secretary of Health and Human Services, March 5, 2018 at the Federation of American Hospitals’ conference
Obstacles in the Path to Value-based Payments
There are many obstacles that must be addressed to successfully implement value-based payments models that reward providers for positive performance and encourage poor performers to improve. In order to achieve the expected outcomes and performance required by VBP, health plans must have the flexibility to develop, implement and administer value-based contracts with providers responsible for care delivery, care management, and care coordination across the medical neighborhood.
How to get there from here…Value-based Payments
On Thursday, March 22, 2018 at 2:00PM ET, Harry Merkin of HealthEdge and Dave Mika of Independent Health will share their insight and real world experience on how to get from here to there with value-based payment. Some of the information they will share includes:
Essential elements of a transition from traditional Fee For Service to Value-based Payment
Independent Health’s story of how important technology-driven strategies are to their adoption of value-based payments
How models being driven by CMS are also impacting commercial contracts
How some health plans are responding to the value-based payment movement including findings from a study of value-based care payments by Humana
The importance of primary care physicians as critical to transforming the way health care is delivered
The type of technology support needed by health plans and providers
The move to value-based reimbursement is inevitable, and only those health plans that adapt will be successful in the future. And developing the capabilities to effectively respond to change doesn’t happen overnight.
Reserve your seat today and learn how to get there from here…
Thurs, March 22, 2018 | 11:00am PT / 2:00pm ET
Learn About Value-Based Payments from Industry Thought Leaders
Presenter – Harry Merkin
Vice President of Marketing, HealthEdge
Harry Merkin has worked with both payers and providers through many dynamic changes in healthcare for a number of years. He is currently responsible for Marketing at HealthEdge, including product marketing, demand generation and thought leadership. He previously had similar responsibilities at Evariant and NaviNet and has collaborated with many transformative entities across the healthcare landscape. Harry has helped introduce and promote innovative enterprise software solutions that enable payers to improve their competitive effectiveness, as well as perform valuable communications between payers and providers, and allow providers to effectively collaborate with patients and consumers as well as with each other
Co-Presenter – Dave Mika
Vice President, Enterprise Core System Operations, Independent Health
Dave Mika plays an integral role in leading the operations unit at Independent Health, located in Buffalo, NY. He is responsible for the coordination of activities across the organization to more effectively manage workloads and partner closely with individual business unit owners to achieve operational excellence. A former Army Reserve combat medic and Licensed Practical Nurse with more than 30 years of experience in the health insurance industry, Mika has also held management positions in member appeals, provider relations, project management and product development and implementation.
Many people familiar with the HealthCare Executive Group (HCEG) know that the HCEG Top 10 list has been a keystone of the HealthCare Executive Group for over a decade – 13 years to be exact. The HCEG Top 10 identifies the current opportunities, challenges and issues that HCEG members and their healthcare organizations face during this era of healthcare reform and transformation. The items on the yearly HCEG Top 10 serve to encourage continuous and evolving dialog and drives HCEG’s programming, webinars, blogs, whitepapers, research and discussion throughout the coming year.
HCEG Top 10 as Basis for the Industry Pulse
The HCEG Top 10 also serves as the framework for the Industry Pulse – an annual research survey conducted jointly by HCEG and Change Healthcare. The Industry Pulse research survey collects additional insight, experiences and opinion on specific items of the HCEG Top 10 list. Healthcare executives, thought leaders and other industry participants serving all areas of healthcare may participate. The results of the Industry Pulse can provide valuable, relevant data-driven advice and end-to-end industry insights to help healthcare leaders navigate the complexities of our rapidly evolving healthcare system.
Share your Insight Today!
HCEG and Change Healthcare would like to invite healthcare leaders from across the nation to participate in the 2018 Industry Pulse research survey and to backdrop and contrast their own perspectives against the 2018 HCEG Top 10.Please consider sharing your insight, experiences and opinion as your perspective will help define the issues facing healthcare, and reveal how the industry is responding.
Everyone who completes the 8th Annual Industry Pulse Survey will be among the first to receive survey results as well as exclusive access to future webinars, content and events that will be delivered over the new year; expounding on survey results and providing additional insight and value to all healthcare constituents.
Today marks the start of National Health IT Week (#NHITWeek,) a collaborative and partner-driven event whose purpose is to promote the awareness and demonstrate the use of information technology in:
Supporting Healthcare Transformation: The many ways in which health IT is driving transformation in healthcare delivery including improvements in quality and safety, interoperability, advances in innovation, and patient and consumer activation and engagement.
Expanding Access to High Quality Healthcare: Use of innovative technologies including telehealth and remote patient monitoring to improve healthcare access, coordination and outcomes.
Increasing Economic Opportunity: Highlighting the importance of a robust, diverse health IT workforce and health IT’s role in supporting economic growth.
Making Communities Healthier: The fundamental role health IT plays in supporting population and public health
As a group of executives, thought leaders and advisory partners serving health plans, health systems and provider organizations throughout the United States, the Healthcare Executive Group (HCEG) is proud to partner with and to support National Health IT Week and the above points of engagement – this week of October 2 – 6, 2017 and throughout the year. You can learn more about #NHITWeek and related events here.
The 2018 HCEG Top 10
To kick of National Health IT Week, the Healthcare Executive Group is pleased to announce the formal release of the 2018 HCEG Top 10 list of opportunities, challenges and issues facing executives of health plans, health systems and provider organizations in the United States.
The HCEG Top 10 has been a keystone of the Healthcare Executive Group for over 13 years and provides insight into the most current, pressing priorities facing their industry. Based on HCEG member input and sponsor partner research, the HCEG Top 10 serves as a framework for continuous and evolving dialog among healthcare executive members on the critical opportunities, challenges and issues facing their organizations. Educational programming including periodic Executive Leadership Round Tables, research initiatives, monthly webinars, whitepapers, blog posts and ongoing member discussion are all driven by the HCEG Top 10.
Help Spread the Word About National Health IT Week
Never before has the digital transformation of healthcare been so pervasive and rapid. Health information technology is key to advancing the imperative points of engagement emphasized during National Health IT Week. Please join the conversation on social media by using the #NHITWeekhash tag. Share how you and/or your organization is using health information technology to transform points of healthcare and health outcomes.
HCEG will be participating in NHIT Week by sharing content via its social channels, member LinkedIn pages, and via this blog. For more information, insight, ideas and commentary about National Health IT Week, healthcare, healthcare information technology and the digital transformation of healthcare, consider following us on Twitter, LinkedIn and Facebook – and subscribe to our eNewsletter.
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!
The Annual Forum hosted by the Healthcare Executive Group (HCEG) is the Goldilocks of Healthcare Gatherings. It’s not too big like the HIMSS Conference and the AHIP Institute. It’s not too small and too narrowly focused like so many of the single topic, function-specific events taking place all over the United States on any given week of the year. HCEG’s Annual Forum is a well-crafted gathering covering an agenda presented by credible industry leaders to a manageable group of attendees in an intimate and comfortable setting. HCEG’s Annual Forum is Just Right.
The 2017 HCEG Annual Forum – It’s Just Right!
This year’s Annual Forum takes place in what’s arguably the Healthcare Capital of the United States: Nashville, TN! Healthcare executives and thought leaders representing health plans, health systems, provider organizations and physicians – along with a select set of healthcare vendors – will gather at the Thompson Hotel Nashville on September 18th through the 20th to participate in this Just Right event.
Here’s a sneak peek at the topics, speakers and valuable activities planned for the 2017 Annual Forum in Nashville. (*Sessions and Presenters Subject to Change)
Certain Topics in an Uncertain Healthcare Environment
Based on the HCEG Top 10 and recent survey’s completed by healthcare executives and others, HCEG board members have identified the following topics that will be addressed in various sessions during the forum:
Value-Based Relationships leading to Payer/Provider Integration
Precision Medicine and Behavioral Health Aspects of Substance Abuse/Opioids
Leading Edge Technology / Disease Management / Population Health
Technology Innovation and M&A Market Trends
Total Consumer Health
Harnessing Digital Health Technologies
A number of well known AND well qualified individuals will be presenting at the Annual Forum and participating in various panels. While speaker arrangements are still be finalized, attendees can expect the following roles and industry focus to be represented:
CEO of well known, nationwide health and wellness company
Chief Marketing Officer of a Fortune 50 technology company
Former executive director of national healthcare association
Former leading official from the Centers for Medicare & Medicaid Services
CEO of large multi-state healthplan
Chief Medical Officer of large BCBS licensee
President of national health care intelligence and policy consultancy
Besides the wonderful breakfasts and lunches catered each day of the forum, and the plentiful snacks and drinks available each day of the forum, a few other special events – all fueled with great food, drink and conversation – are part of the Annual Forum.
Sunday Evening: Meet and Greet at The Thompson Hotel
In this second post, select insight, ideas, comments and opinions on Topic #2: What must health systems & health plans focus on over next 8 to 18 months regardless of health reform outcome? are shared. The remaining topics will be addressed in future posts.
Precision medicine (aka ‘personalized medicine) was a hot topic at this week’s #AHIPInstitute in Austin.
Patients with complex needs require a custom approach. Personalized medicine promises to improve outcomes at lower cost.
Be excited when we get to the point where #AI effective for health plans. We’re still collectively digging for gold in claims data.
Implementing positive changes in the healthcare industry that give clinicians the opportunity to view #PatientCare in a new light
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
It wasn’t that long ago that HC plan leaders were saying “HC plan members aren’t consumers,” LOL
Addressing the healthcare needs of the #aging population of the country will need to take a seat in the front row
Taking advantage of the data we are given to visualize the patient condition and identify at-risk patients earlier
Getting members engaged and empowered in understanding, maintaining, and improving their own health journey
Consumerism has been making inroads into healthcare, patients are acting like consumers about their healthcare options
Until patients “get it” health outcomes can only improve so much
Importance of Basic Health Education, Literacy & Preventive Care
Improving basic health education & literacy through active & coordinated outreach to members & patients is a big opportunity
Improving education & literacy can be as simple as adopting universal languages so plan members aren’t constantly confused
More focus to prevention & wellness. Reach patients before they get ill or have a major medical event.
We need to focus more on prevention – spending too much on too few people – and often late in life.
Customer Relationship Management
Customer service is an area of opportunity, healthcare needs to accept the change and adapt accordingly
Before the healthcare industry dives into AI – they should incorporate basic CRM functions into #EHR systems. Huge communication disconnect!
Addressing the need for clinical decision support and getting the right information available at the right time
Data is Critical to Healthcare
Challenge w/ personalized medicine starts w/ lack of ability to accurately identify correct patient some crazy % of time…
And, of course, standardizing data (#interoperability) to encourage cooperation between all #healthcare entities
Systems that can use unstructured data to inform decisions. AI and machine learning?
Real-time data sharing, especially clinical data, with providers and especially patients
Absolutely! RTI approach needs to be incorporated from data driven perspective
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
Health data taken from the home of the patient using this technology can be shown to doctors for perhaps better, tailored care
Another area to take advantage of is using technology to bring healthcare to the home of patients.
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
How about better assessment & collection of what matters to members/patients? Instead of fancy analytics from quants?
How do we measure feelings and happiness? Or are outcomes more quantifiable?
System wide outcome driven treatment and outcome measures to tailor individual client centered care. Educate for prevention
Analytics allows for effective clinical assessments by providing better patient outcomes
We’re trying to do this now, in way, with HCAHPS/CAHPS, right? Don’t believe currently effective, but CAN be quantified.
Do you see a worthwhile set of quality measures worth aligning to?
Great idea: patient-centric measures. What outcomes do patients/members want to achieve, and what data do we need to drive them?
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.
The HCEG Top 10 list of healthcare priorities, challenges and risks faced by healthcare industry executives is developed each year at HCEG’s annual forum. For the past seven years, the HCEG Top 10 list has served as the keystone for industry wide analysis, and subsequent research: The Industry Pulse, an annual survey initiative, conducted over the past seven years in partnership with Change Healthcare – a sponsor partner of the Healthcare Executive Group.
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 7th Annual Industry Pulse Research Survey
On March 29th, a webinar provided an overview of highlights from The Industry Pulse was shared here to help industry leaders better understand the current healthcare environment, as well as to prepare for, and navigate, change. The webinar offered an initial interpretation of research survey results across the following topic areas:
The Current State of Clinical & Data Analytics (HCEG Top 10 Item #3)
Privacy & Security in a Data Driven Environment (HCEG Top 10 Item #4)
Customer Service: Cost vs Quality Transparency (HCEG Top 10 Item #5)
This post presents a recording of that webinar including the entire slide deck presentation and an infographic presenting some key findings from the 7th Annual Healthcare Industry research survey.
More Insight, Trends & Analysis
Over the following weeks and months, additional analysis and insight will be gleaned from The Industry Pulse and shared by HCEG and Change Healthcare. To stay abreast of the unique insight offered by the Healthcare Executive Group, the HCEG Top 10 list and The Industry Pulse research survey, be sure to subscribe to our newsletter and follow HCEG on Twitter, Facebook and LinkedIn.