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:
Actionable insight and ideas shared by HCEG Members & Sponsor Partners
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.
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.
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
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)
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)
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)
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?
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.
Brick & Mortar Bring Human Interaction and Touch to Accident & Disease Prevention
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.
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
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.
These three health industry leaders shared their insight on the following:
How challenges, issues, & opportunities have evolved over the last few years
How they’re transforming and innovating their organizations
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
What excites them about the future for health care
The remainder of this post shares a few highlights from the session. Access all recordings mentioned in this blog post here.
Costs & Transparency, Consumer Experience, & Holistic Individual Health Top 2020 HCEG List
Costs & Transparency, Consumer Experience, and Delivery System Transformation – the key themes of the AHIP-Consumer Experience & Digital Health Forum – also ranked as the top three items on the 2020 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leadership. In addition, ‘Holistic Individual Health’ is ranked as #6.
Ferris Taylor kicked off the session by asking Dr. Lopez “What keeps you up at night?”
The value that payers bring – is not networks or care management services – although those are important. Their true value is data and analytics. How do we consume data and use that data to derive value for our members so they can stay healthier? How do we use that data to engage with our providers to deliver value-based healthcare?
Over the last several years, providers and payers have become more efficient. At the same time, members have not become worse off but they’re also not becoming better. But there’s still opportunity.
Health plans need to ask:
How do we use the data we have in a meaningful way?
How do we couple other readily available data with open-source consumer information and other types of information we have about our members so we can predict outcomes, predict disease, and find the channels where we can best engage our members
How we can find the channels where members/patients can best be engaged?
New Generations Demand New Levels of Engagement & Value
External disruptors are out there, and they know how to engage healthcare industry incumbents. People want the Amazon Experience and right now, healthcare is NOT like the Amazon Experience. Especially as we look at Millennials, Generation Z and other generations of Digital Natives, we know that they will not stand for the experiences they are having today in healthcare.
The health system itself and health care payers specifically have spent a large portion of their existence contemplating their own value buttons. We look at things very much from an inside-out perspective. And that’s been very useful until we’ve come into the age of consumerism. At this time, we need to continue, which we’ve started that migration, to look at things from the ‘outside in.’
We talk about the power of members. The power of consumers. As opposed to people. We don’t own them. They own themselves. The more information we have, the more we can create models and services and products that meet the needs of PEOPLE!
Health plans talk about social determinants of health. I like to think about ‘Social Determinants of Health’ as ‘Social Determinants of Individual Happiness’ – of which health is a component.
Focusing on Point Solutions Health Plans Want vs. Overall Holistic Health
Ian related a scenario highlighting how many health plans are not properly focusing on holistic health of the individual. Some highlights include:
Health plans give members things they want to address to drive down medical loss ratio; as opposed to the broader aspect of overall happiness of which health is a component. We give members program’s and tell them to lose weight and do more activities. And then we wonder why they don’t succeed. And the reason they don’t succeed is because they ate too much.
We need to look people more holistically at individuals, focus more on their individual needs, find out what is our role, data, access to healthcare, the digital transformation needed to create that personalized service are all the key things, I think, that are necessary.
Healthcare is complex and it’s hard to learn but so are a lot of other things. And given the right amount of time, the other organizations (disruptors) will encroach upon the health plan. So, health plans must focus on the holistic component of individuals. What makes them happy and improves their lives. And we need to figure out how to do that with data and become an expert at that. Or partner with others who can do that. And we need to stop trying to compete on the commodity-based components of our business.
Barriers to Improved Health – A Broader Definition of Social Determinants of Health
After both Dr. Lopez and Ian Gordon shared some of their insight and ideas on social determinants of health, Ferris Taylor noted that social determinants of health can also be considered as Barriers to Improved Health. Dr. Lopez shared his insight as a physician in the Emergency Room of a hospital serving a low-income area.
Listen to Dr. Lopez’s ideas on how providers, doctors, nurses, payers, and others can help address barriers to improved health: 13:30 – 17:40
And Ian’s follow on to Dr. Lopez’s ideas based on Ian’s experience with Habitat for Humanity: 17:41 – 19:38
More on What Should Be Keeping Health Care Executives up at Night
The 2nd Annual 2019 HLTH Conference – billed as the event to “Create Health’s Future” – took place in Las Vegas last week. In true Las Vegas fashion, the HLTH organizers created an event that was brighter, shinier, informative and certainly more entertaining than last year’s inaugural HLTH event. Unlike some conferences that lean toward specific sub-groups of attendees – like health plans, providers, and investors – the HLTH conference offers something for all of healthcare’s constituents. Over 6000 attendees, speakers, and others representing healthcare providers, payers, life sciences, investors, and government – converged on the MGM Grand hotel to share their insight, ideas, and opinions about creating healthcare’s future.
As is the case with most healthcare conferences nowadays, sessions at HLTH were organized into tracks whose content varied each day. Over the four-day long HLTH conference, a total of 19 different track themes were presented. Like last year’s HLTH event, organizers assigned all sessions in each track to the same room location; making it easy to navigate between tracks and sessions. Also similar to last year, there were a few crowded sessions and some rather sparsely populated sessions. An interesting addition to this year’s sessions was the closed captioning displayed on a large screen in front of the presenters.
Based on a review of the HLTH conference agenda and some of the early recaps shared by other attendees and media, a few common threads dominated the HLTH event:
Cost & Transparency Needed to Create Health’s Future
Given the unabated rise in costs, it was no surprise that greater financial transparency was a dominant theme in HLTH keynotes and sessions. Many of the sessions at the HLTH event addressed the importance of providing cost-effective services and products to three groups of people:
People with multiple chronic conditions – particularly diabetes, hypertension, hyperlipidemia, asthma, and depression.
Patients who drive a large percentage of total health care costs
Patients discharged from the inpatient setting
Social Determinants of Health – aka ‘Barriers to Health’
As has been quite popular over the past 5-6 years, quite a few speakers and panelists spoke of the need to extend health services beyond the walls of the treatment room and out into the local community.
Not surprisingly, Uber and Lyft – and a number of companies seeking to sit between these non-emergency medical transportation giants – had a significant presence in the sessions and the exhibit hall. Several sessions mentioned other non-medical services that Medicare Advantage and some other plans are offering members – like personal emergency response systems, home safety assessments and modifications, home environmental services like pest control and air conditioning.
Voice Technology Will Be Huge – Just Add Trust to Create Health’s Future
The ‘Voice First’ approach to improving customer and patient experience in the healthcare industry was shared by presenters in the Voice.HLTHtrack. And voice technology was observed as a key aspect of the product and service offerings from more than a handful of HLTH exhibitors.
It should be no surprise to anyone reading this that ‘Building Trust is Essential to Transforming the Healthcare System.’ This sentence was shared over and over and over again in many of the sessions. And the HealthCare Executive Group did its part in promoting this all-important quality that the healthcare industry needs more of.
In the “Unlocking Voice Tech’s Power” session on Tuesday, October 29th, Dr. Rasu Shrestha, MD, MBA of Atrium Health, shared the following in regard to consumer adoption of voice technology:
“Think about trust as perhaps the most valuable currency that exists in healthcare and trust is really difficult to build and to nurture and grow but it’s really easy to break” – Dr. Rasu Shrestha, MD
Read more about how ‘Building Trust is Essential to Transforming the Healthcare System’ in this recent HCEG post.
Non-Traditional Innovators & Return to Bricks and Mortar
It was clear from all the sessions and exhibitors that healthcare is witnessing an insurgence of non-medical providers and a resurgence of traditional, physical locations where health care is delivered:
Larry Merlo of CVS Health shared how CVS is opening up 1400 “Health Hubs” and that traditional and non-traditional ‘providers’ serving health plan members and healthcare patients need to ‘consider all the activities before and after a patient is in a physician’s office.’
Marcus Osborneof Walmartthen went on to echo Merlo’s point by sharing a virtual tour of Walmart’s new Health Center conceptwhere primary care services, diagnostic tests, mental health services, dental, optical, hearing, fitness, and other community health benefits are offered. And then a ‘health navigator’ walks the healthcare recipient through Walmart’s store where they can obtain many of the products they need.
In addition to the above, executives from Google, Facebook, Twitter, Microsoft, Oracle, Samsung, and Apple also shared their insights.
Thinking Outside the Hospital Room to Create Health’s Future
Similar to the return of bricks and mortar service care settings previously mentioned, many of the keynotes, conference sessions and products/services offered by exhibiting vendors at the HLTH conference addressed the growing movement to provide more healthcare in the home. Many of the vendors aspiring to enter this space between traditional hospital places of service and the patient’s home are focusing on coordinating services between established large companies and individual health plan members and patients.
In addition to a focus on coordinating non-medical services and addressing determinants of health impact outcomes and costs, the challenges, issues, and opportunities for providing home-based and telehealth services were the dominant themes.
More than a few HLTH sessionsspoke to the need for increased focus on collaborating, integrating, and developing products and services that put individuals – specifically females – and their health needs at the center of improved outcomes and lower costs. With women making the clear majority of healthcare’s buying and usage decisions, it’s no surprise that “gender parity’ was a general theme. Some ways that parity for women in healthcare was advanced at the event include:
One aspect of the HLTH conference that sets it apart from most all other healthcare conferences – at least those with multiple 1000’s of attendees – is the meals provided by HLTH. Serving a varied, hot meal to 5000+ people is no trivial matter and HLTH did a remarkable job in that regard. Some other interesting ‘accompaniments’ to the HLTH conference – apparently intended to create a relaxing and energizing atmosphere included:
Dark hallway illuminated with neon signage – to transition attendees from the shiny, glittery hotel-casino to the shiny, glittering HLTH venue
Mimosa’s in the registration line – to calm those early morning nerves and get attendees in the mood for networking
Musical jazz quartet at lunch – pleasant sounds from a quartet of young women
Patio Lounge – a great place to get fresh air and network with fellow attendees
Coffee, tea, and water all day long – to save time waiting in lines and keep the dry desert air at bay
The Bumbys– a very entertaining couple of people who silently and humorously judge your appearance
Docents to guide your way – ever-present individuals to help you find your way and answer your question
Executive Leadership Roundtable – HCEG, CHI, IAIOP and WEDI
Like last year, HCEG partnered with the Center for Healthcare Innovation (CHI), the International Association of Innovation Professionals (IAOIP), and the Workgroup Electronic Data Interchange (WEDI) to present a special three-hour-long roundtable event.
In an effort to Create Health’s Future, HCEG co-hosted a special HCEG Executive Leadership Roundtableat the HLTH conference. We partnered with the Center for Healthcare Innovation (CHI), International Association of Innovation Professionals (IAOIP), Workgroup for Electronic Data Interchange (WEDI) and special guests,Dr. Jason Woo, MD, MPH, FACOG, Dr. DeLeys Brandman, MD, andDr. Sunnie Giles to present a three-hour roundtable on the last day of the forum. See “Flying the Plane While Building a Plane: Do you have what it takes to pilot the transformation of healthcare?” for a recap of that special roundtable event.
This event, titled ‘Flying the Plane While Building the Plane: Do You Have What It Takes to Pilot the Transformation of Healthcare?’ offered the opportunity for session attendees to discuss the following:
How the digital revolution makes leadership, transformation and innovation more challenging, especially for healthcare organizations transitioning to a consumer-centric focus
Identifying hidden barriers that keeps leaders from creating a workplace culture that supports long-term success and leading-edge technologies
Personal success factors (expertise, knowledge, technical skills) that distort your ability to see problems clearly and truthfully
Approaches to adopting the values required for digital transformation while recognizing the value of legacy businesses
Ideas on addressing the public’s declining trust in US health care systems
Seventy people attended this session hosted by our sponsor partner Appian. For more info on this roundtable, see this post.
Other Recaps of the 2019 HLTH Conference
Over the past week, several other healthcare thought leaders and industry participants have shared their insight on the HLTH event.
Journalists Help Create Health’s Future – Power Press Party
Dennis Dailey, the publisher of mHealthTimes, held the 4th annual Power Press Party at the 2nd Annual HLTH Conference. The Power Press Party showcased the latest, brightest and very best of healthcare journalism from national healthcare reporters, influential trade journalists, industry publishers, editors, social media ambassadors, and analysts. And great food and drink were served to all!
More Insight and Ideas for Healthcare Executives to Create Health’s Future
HCEG invites healthcare leaders from across the nation to participate in the 10th Annual Industry Pulse research survey. Please consider sharing your insight, experiences, and opinion to help define the issues facing healthcare. Your insight will help to reveal how the industry is responding in today’s uncertain environment. Learn more about this survey and share your insight here.
The 2019 AHIP Institute & Expo took place in Nashville, TN earlier this month and our Executive Director Ferris Taylor was in attendance – along with many of our members and sponsor partners. This post shares just a bit of what Ferris observed. Also included are some recaps of the event shared by industry media and analysts.
Cigna CEO on Importance of Access, Affordability, and Eliminating Surprises
Wednesday’s afternoon keynote, A Blueprint for a More Sustainable Health Care System, was presented by David Cordani, President & CEO of Cigna Corporation. David’s introductory message emphasized the importance of access, affordability, and eliminating surprises. During his 45-minute session, David shared the following thoughts and ideas – among others:
Healthcare organizations – and the companies that support healthcare organizations – need to understand the needs of the people and companies they want to do business with and then earn the “right” to meet those needs.
In the quest for the digital transformation of their healthcare organizations, healthcare leaders should consider and address the “transactional going to transitional going to transformational”
Treat the whole person and be sure to do your best to connect individuals (plan members and patients) with providers. Drive this change through innovation
Some statistics shared by David Cordani
The United States is the only place in the world you want to be if you have a critical medical conditional.
In 1992, the healthcare industry resisted
In 2008, the healthcare industry collaborated
In 2020, will the healthcare industry choose to lead?
What is the Health Care Cost Institute (HCCI) and Why Should You Care?
For those who may not know, the Health Care Cost Institute (HCCI) is the first qualified entity recognized by CMS for quality, efficiency, and use of resources. The speakers shared an overview of the benefits of collaborating and sharing data with HCCI and how HCCI members have access to the following types of Healthcare Market Intelligence:
benchmarking enrollment, utilization, and payments
provider profiling (understanding and tiering networks)
care management (patient identified data)
custom analysis (utilization of care, alternative payment methods, Rx, etc.)
Niall Brennan will be presenting the breakfast keynote at HCEG’s 2019 Annual Forum on Tuesday, September 10, 2019. For more information about our Annual Forum, clickhere.
Niall also shared some information on the National All Payer Claims Database (APCD) and emphasized that without data, states without APCD’s are flying blind with little or no ability to assess cost or quality. The group urged all attendees with the power to do so, to submit their data to HCCI and then focus on using the information and data HCCI generates in return to for quality and improvement programs.
Additionally, a general consensus among the speakers was their surprise that employers are not outraged over the variation in healthcare prices and even more with the fact that, while demand for some services is declining, in many cases prices are still going up.
For more information about HCCI including how to become a partner, click here.
AHIP President & CEO Matt Eyles – Speaker at HCEG’s 2019 Annual Forum
At the AHIP event, Matt Eyles, AHIP’s CEO & President, shared his take on “What the Industry needs to do to address Health Care’s Challenges.” Matt will also be speaking at HCEG’s 2019 Annual Forum on Tuesday, September 10, 2019. For more information about our Annual Forum, click here.
Social Determinants of Health at AHIP Institute & Expo
Unsurprisingly, social determinants of health – ranked #3 on the 2019 HCEG Top 10 list – was a popular topic at the AHIP Institute & Expo. Check out these articles and resources on this hot topic impacting health plans, health systems, and provider organizations.
The following is a verbatim transcript of that interview – with a few links and supporting information added in for clarity. You can watch the actual recording here and sign up to receive our eNewsletter here.
Talking About the 2019 HCEG Top 10 List at World Health Care Congress
Mabel Jong: And welcome back. I’m Mabel Jong and you’re watching live coverage of the World Health Care Congress on WHCCTV. Thank you so much for joining us.
We’re going to learn a little bit about the HealthCare Executive Group. Their executive director Ferris Taylor is here.
Ferris Taylor: Well thank you Mabel, it’s good to be with you.
I understand you’re from Boston where the HealthCare Executive Group started in 1988 in Maynard, Massachusetts when a mini computer manufacturer disbanded their healthcare user’s group. That group of users said: “Forget about Digital Equipment, we find value in networking, being able to share the challenges and the opportunities of healthcare” To have somebody around the country that I can pick up the phone and call and say: “Hey, I’m having this problem.”
And if my colleague in Minneapolis says: “I’m not having that problem,” then maybe there’s something wrong with me. Or maybe, we have something to talk about. Or if we both have that problem, then how are we solving that?
So, it’s a small network 100 members or so, primarily technology leaders in their organizations, payers, and providers that find personal, professional and organizational value in sharing ideas about how to address the challenges in healthcare. And as you know, we have lots of lots of them.
Mabel: Lots of them. And in terms of sharing ideas, you also have done a lot of research on coming up with a top 10 list. Not David Letterman’s top 10 list but…
Ferris: It started out that way.
Mabel: Okay. Share with me what this list is about and who makes it.
Ferris: And it’s fascinating because from the very beginning there was always a conversation about the challenges in healthcare. And 10 or 15 years ago the CIO at Health Partners,
Alan Abramson said: “You know, when I go home from our meetings, my executives asked me what we’d been talking about and I tell them.”
But there would be value if we actually went through a process and shared with the industry what our members see as the challenges in the foreseeable future in health care.
So about 15 years ago we started publishing, and at the time it really was (based on) the David Letterman (Top 10 list). We keyed on that – ‘here’s our top ten list.’ And it’s evolved from that. Our members at the end of the year actually vote from a list of 30 or 40 issues that we talked about in the year – what their top 10 issues are. And then we go through a process of ranking them and it (HCEG’s Top 10 list) becomes the benchmark that our members use.
And I recommend that other companies, other healthcare stakeholders around the industry use the Top 10 list to ask themselves: “Am I addressing these issues? Are they on my priority list? What’s my action plan with respect to those issues?”
Mabel: Okay. So, does it go from most important to…
Ferris: We do rank them.
Mabel: Okay. So, number one, you have Data and Analytics all the way to number 10 cybersecurity.
Ferris: That’s a big range.
Mabel: That is a big range. So, people are saying these are the issues that we’re currently facing and that we’re concerned about.
Something Old, And Something New on the 2019 HCEG Top 10 List
Ferris: Exactly. And another dimension of this that you don’t see but is very important is that I can look back over time and see how those issues have moved around. Up until 2015, cybersecurity wasn’t on our list. And then you have two major health plans – 80-million-member record breach, 20-million-member record reach. So a 100 million members records have been lost to the dark side.
Mabel: So, it made the list.
Ferris: Right. And the fact that it’s number 10 doesn’t mean that it’s not important but other things have become more important. Number four is Value-Based Reimbursement. And World Healthcare Congress this week has talked a lot about value and clinical appropriateness of price and those issues.
Three years ago, value-based reimbursement was number one on our list. You could say: “Well it’s dropped in importance.” But in fact, if I look back over our conversations – and we have monthly webinars and do a lot of blogging and then we have quarterly executive roundtables where we take these issues and discuss them in our annual meeting, we spend a hold three days on the program. The discussion was: we can’t get to value-based payments until we have a better handle on data, and in particular, clinical data. We’ve got a lot of claims data but we need the clinical data and we need agreement on the majors and the outcomes and the data we’re going to track before we can get to value-based reimbursement.
Of Course, Social Determinants of Health Are On the List
Ferris: We need to bring the consumer in. Number two is Total Consumer Health. Number three is labeled Population Health Services. We call it social determinants of health but it’s really the barriers to medical health that are non-medical. And we’ve narrowly defined healthcare as medical and it isn’t.
Mabel: Well also, at number nine is Opioid Management.
Ferris: And that’s a new one this year.
Mabel: Yes. I can imagine it would be.
Mabel: But it’s a crisis and your executives are very concerned about this.
Ferris: They are. And on all of these issues. They’re corporate issues. In our discussions, many times they’ve evolved to: What are the systems? What are the data flows? What is the information? What is it that we’re trying to track that will help us, help our executive team address or better handle a crisis like opioid management?
Using the 2019 HCEG Top 10 List to Define and Frame Problems
And you know, from a technology point of view, you could say: “Well that’s a medical issue, it’s not a technology issue.” But, in fact, in our data for a number of years, there were indicators that this was becoming a problem and we didn’t analyze it.
Mabel: I see. Okay. So now that executives have outlined these as their concerns, what does your group do about that?
Ferris: Well, we’re very action-oriented. But to get to action you’ve got to be very sure you define the problem correctly and have the components of the solution in place before you take action. And so, a lot of what we’re focused on are, as a group, here’s what I’m doing from a system and a technology point of view to address each one of these issues.
And their colleague in another part of the country, somebody that they don’t compete against. So they can be very open and sharing are saying: “Well you know, in addition to that I’m doing this.” And the colleague may respond: “Oh, I hadn’t thought about that. I need to bring that to the table as well.” And then they can go to their management team in a very organized and comfortable way saying: “This isn’t just my idea. This is what a group of our colleagues that are similar to us is doing.”
A Common Frame of Reference For Healthcare Leadership
And it gets better acceptance. It allows these things to become priorities within each company’s competitive marketplace because everybody’s different with their resources with the focus that they have on health care.
If you’re a Medicaid plan you have a different focus than if you’re a Medicare, commercial or a dual-eligible plan. So, it’s the networking that leads to the actions that can take place here.
Our closing session yesterday here at World Health Care Congress was two of our board members. Board chair Kim Sinclair from Boston Children’s Medical Center and Alan Abramson from Health Partners sharing with everybody here at World Healthcare Congress what they see out of these as their priority. And going into specifics: these are the things that we are doing to address the challenges that we’ve already acknowledged.
Mabel: All right. Ferris, thank you so much for sharing your experience with HCEG. We appreciate it.
Ferris: It’s a lot of fun all right.
Mabel: Thank you for joining us stay tuned we’re rounding out our last interview very shortly.
Join Other Healthcare Leaders to Digitally Transform Your Organization
For more information, insight, and ideas about the challenges, issues, and opportunities facing healthcare leadership during these uncertain times, consider these opportunities:
Last week a lot of planning, coordination and content development by the HealthCare Executive Group came together at the 16th Annual World Health Care Congress in Washington, DC. For this year’s congress, HCEG partnered with World Congress Events to present the CIO & CTO Strategy Track. This post recaps a few highlights of the 2019 World Health Care Congress, shares some insight from the healthcare leaders and champions presenting at the event and in our the CIO & CTO Strategy Track, and provides some select presentation materials, recordings and other content from the event.
HCEG Top 10-Related Highlights From 2019 World Health Care Congress
As expected, many of the sessions and keynotes at the WHCC event addressed items on the 2019 HCEG Top 10 list with “social determinants of health” (#3 on the 2019 HCEG Top 10) and “value-based payment” (#4 on the 2019 HCEG Top 10) being pervasive themes throughout the keynotes, sessions and exhibit hall.
Value-Based Care – It’s More Than Just Adding An Alternative Payment Model
One of the sessions in the Provider Transformation track, ‘Do Medicare Changes Enhance or Hinder Clinical and Payment Transformation‘ emphasized the role of the primary care doctor in the shift from the dominant fee-for-service reimbursement model to new value-based-payment methods. Panelists also called out that to truly transform our health care system, change must not just focus on payment models but also deliver scalable clinical and operational methods. And HCEG members acknowledge this as “Operational Effectiveness” is ranked #8 on the 2019 HCEG Top 10 list.
Defining, Measuring, and Communicating Quality Measures are Key for Leveraging Social Determinants of Health
Another session titled “SDoH Business Strategy: Quantify and Communicate the ROI and VOI of SDoH Initiatives” shared the following key points and considerations for healthcare organizations looking to address social determinants of health as barriers to care:
Quality measures that incorporate social determinants of health must be developed and understood BEFORE starting programs and initiatives.
Readily available public data is not granular enough to capture SDoH factors needed appropriate quality measures.
Conducting clinical trials on proposed quality measures can help to understand and quantify the benefits of SDoH initiatives.
Incorporate patient/member personalization into a standardized, common infrastructure that enables economies of scale.
Predictive analytics – a perennially high-ranking item on HCEG’s Top 10 lists – is THE critical component of SDoH programs.
Combining clinical data from EHR’s with claims and other administrative/demographic data records allows health plans/health systems opportunities never before easily attainable.
Health plans, health systems, and providers must clearly understand and communicate the benefit that addressing social determinants of health can have for their members and patients.
Organizations should strive to assign a financial measure assigned to each quality measure.
CIO & CTO Strategy Track at World Health Care Congress
Alan Abramson shared four areas of focus for HealthPartners:
Formally chartering projects to deploy technology-based approaches to largely manual processes
Carving out and focusing on efforts to improve patient experience
Address inefficiencies in technology ecosystems, business policy, and processes
Establishing R & D projects to assess opportunities and benefits of new, emerging technologies
Increasing Operational Effectiveness in Health Plans & Health Systems
Alan went on to share that the #1 initiative his healthcare organization has been focusing on last year, in 2019 and will continue to focus on in 2020, is increasing Operational Effectiveness (#8 on the 2019 HCEG Top 10). Alan provided some examples as to how HealthPartners is achieving greater operational effectiveness including:
Utilizing Lawson Financials to consolidate multiple disparate functions
Rehosting and re-platforming administration systems such as employer group setup, utilization management reporting, new member enrollment, and patient admission, discharge and transfer.
Positioning systems, policies, and procedures to accommodate increases in individual health plan coverage
Consolidating four different laboratory systems into one system
Using Robotic Process Automation (RPA) to automate user administration and security
Using AI-powered bots to automate 27,000 software QA tests that took three weeks to complete and that now take 17 hours.
Alan noted that achieving success via ‘standardization’ in one area often leads to end users demanding improvement via standardization in other areas.
Payer-Provider Data Sharing and Interoperability Critical in Risk-Sharing Relationships
Kim Sinclair’s healthcare organization serves approximately 400,000 members and patients via its health plan, hospital, and medical centers – 80% of whom are Medicaid beneficiaries and represent 15% of the state’s Medicaid population.
Like other integrated healthcare delivery systems – especially those entering the nascent world of ‘accountable care,’ Kim noted that investments in provider network management and payer-provider interoperability have often lagged that of other initiatives. Moreover, a competitive market with many small medical practices lacking sufficient IT systems and a tendency to ‘throw bodies at a problem’ has increased the challenges her organization faces.
Kim also shared some examples of how her organization is addressing their challenges, issues, and opportunities:
Integrating various systems with a focus on creating an industry-leading accountable care organization (ACO).
Formal projects to identify and stratify members and patients with complex care management needs.
Revising policies, procedures, teams, and systems to effect a truly integrated system.
Reducing pended claims and time to pay – particularly important where both payer and provider are sharing risk.
Focusing on change management and investing in payer-provider interoperability and support.
Cybersecurity – Think Beyond Enterprise and Employee Training
In this CIO & CTO Strategy Track session, panelists discussed cybersecurity at the end-user level. They emphasized the importance of leadership having a strong grasp on the ‘foundational’ components of cybersecurity (patch management, identity/access management, perimeter security, etc.) And also encouraged the audience to pay attention to data assets outside their own four walls. For instance, the use of Software as a Services (SaaS) and 3rd parties they contract with (outsourced vendors) who possess their organization’s sensitive data.
HCEG board member Eric Decker and SVP of IT & CIO at Independent Health spoke about how his mid-sized health plan has evolved beyond the core technical cybersecurity team as the ‘first line of defense’ by chartering a Risk Office responsible for creating and testing their cybersecurity framework. His organization also has an Internal Audit team that regularly audits core controls as well as the cybersecurity framework.
Think holistically – consider the psychology of cybersecurity and how to optimize your workforce against threats.
Tim Thull, SVP of IT & CIO at Medica Health Plan spoke about how it is important to have strong oversight, governance, and controls framework around information risk management from your board of directors to individual staff. Medica has implemented HITRUST as common security framework with an information risk program which provides sound technology solutions and controls. Robust training and awareness remain a critical component in ensuring everyone is an active participant in strong cybersecurity defenses.
Optimize Information Sharing to Generate Real Value from Data
Latecia spoke about the importance of viewing data as a strategic asset, explained that “the ‘Why’ we share information matters” and offered some lessons learned during the Opioid Symposium and Code-a-Thon sponsored by HHS.
Data are in silos
Data sharing is inefficient
Analytics capacity is uneven
Data sharing is costly
Video Interviews by Mabel Jong at 2019 World Health Care Congress
One of the interesting and informative parts of the WHCC event was their WHCC TV feature where Mabel Jong – professional on-camera interviewer and panel moderator specializing in healthcare – does short interviews with keynote speakers, session panelists, and other healthcare leaders and champions participating in the Congress.
Mabel interviewed Ferris Taylor, recent Chief Operating Officer of Arches Health Plan and HCEG’s executive director. More about this interview will be shared as the recordings are released. In the meantime, you can find many of the interviews performed by Mabel Jong on the World Congress Events YouTube Channel.
HCEG Member Feedback on 16th Annual World Health Care Congress
HCEG Board members Cate McConnell, Healthcare Payer Industry Practice Lead at Appian Corporation and Eric J. Decker, SVP of IT & CIO at Independent Health shared their insight on the 16th Annual World Health Care Congress:
What was unique about the WHCC event?
Eric:The keynotes went right to the heart of the issues impacting our industry today (transparency, value-based payments, social barriers, member engagement, and affordability). Likewise, the breakout sessions were plentiful and offered a diverse array of topics to choose from.
Cate:WHCC, being in Washington DC, includes policymakers in greater numbers than most conferences. It was good to hear some of the interesting ideas shared by the policymakers. I would have liked to have more people from the current HHS/CMS administration who are shaping healthcare policy speak at WHCC.
How did WHCC’s event differ from what HCEG presents with its Annual Forum?
Eric:Many healthcare conferences – WHCC included – include limited time for questions and answers, not only in the keynotes but also the breakout sessions. The event had nowhere near the time that HCEG’s forum includes for questions (and even debate).
Cate:WHCC is much bigger than HCEG’s annual forum which leads to fewer and less intense opportunities for networking and discussion. The large exhibit hall/show floor can sometimes be a distraction.
What didn’t you see or what could have been better about WHCC?
Cate:Pricing transparency is ‘critical’ in healthcare – in terms of procedures, tests, and drugs – but there weren’t any discussions of how to do this, and what this means to provider compensation. The free market disruptors will likely force this on the industry, which appears unwilling/unready to address it themselves. A speaker made the point that of the two industries that don’t have price transparency – college education and healthcare – prices increase many times greater than inflation because there are no incentives to become more efficient.
What were some things you felt were ‘most important’ for WHCC attendees to absorb?
Cate:Many speakers acknowledged that disruption is coming and that Amazon, Google, and Apple are the prime disruptors. Yet most executives shrugged off this threat with “they will learn healthcare is complex.” This seems to be an “innovator’s dilemma” situation where current industry players are unable to disrupt themselves due to entrenched business models. But what will happen to healthcare if Amazon drives sweeping disruption as it did in retail? Are we ready for widespread bankruptcies?
“External Market Disruption” is ranked #7 on the 2019 HCEG Top 10 list.
Other Recaps & Insight from 2019 World Health Care Congress
Here’s a bit about what others are sharing from the 2019 HCEG Top 10 list at the 16th Annual World Health Care Congress:
A Unique Opportunity for Healthcare Executives, Leaders & Champions
The 16th Annual World Health Care Congress was a great opportunity for those working to transform the healthcare industry during these uncertain times. And the HealthCare Executive Group was honored to have partnered with World Congress Events to host the new CIO & CTO Strategy Track.
For another opportunity to learn about new strategies and approaches to addressing the challenges, issues, and opportunities facing healthcare leaders – and to establish new relationships to facilitate your organization’s digital transformation – consider joining other healthcare executives, leaders, and champions at our 2019 Annual Forum in Boston on September 9th through the 11th. The year’s agenda is centered around the following major themes supported by the 2019 HCEG Top 10:
Technology & Its Role in Transformational Industry Change
Digital Health: Consumer & Organizational
Pharmacy Costs and Opioid Management
In addition, all participants in our 31st Annual Forum will be treated to a special networking event between the Boston Red Sox and the New York Yankees at Fenway Park on September 9th – at no additional charge.
The 2019 HIMSS Global Conference & Exhibition kicks off this coming Sunday in Orlando, FL and runs through Friday, February 15th. 45,000+ professionals from 90+ countries, 1300+ exhibitors, 300+ education sessions spanning 24 topics and 100’s of special programs and networking events will converge to offer comprehensive insight into the current state of the healthcare industry. In addition to many of our members and sponsor partners in attendance, board members of the HealthCare Executive Group (HCEG) and a couple support staff will be gathering content of interest to share, networking and supporting our sponsor partners.
Items on the 2019 HCEG’s Top 10 List Dominate
Not long after last year’s HIMSS Conference came to an end, industry thought leaders, prominent analysts, and media outfits covering the digital healthcare space started predicting the major themes and top trends expected to dominate this year’s HIMSS conference. These themes and trends include…
HCEG Members & Sponsor Partners at the 2019 HIMSS Conference
If you’re at the HIMSS Conference, be sure to check out our sponsor partners exhibits, sessions and the special events they’re hosting. Here are those we know about at this time.
Visit Booth 6543 to learn about Appian’s leading platform for low-code enterprise development. Appian will be providing live demos of their platform on Tuesday, February 12th at 11:30 am – addressing topics such as Clinical Trials Intake, Clinician Onboarding and Credentialing, Home Health Manager, Provider Payment Reconciliation, Utilization Management, and more!
Be sure to Refresh and Rejuvenate Yourself – and your phone – as Appian will be offering complimentary healthy smoothies throughout booth hours each day, along with a relaxing device charging station area for you to take a break. And while you’re at the Appian booth, be sure to have your badge scanned for a chance to win a Vitamix to create your own smoothies at home or an Apple Watch Nike Plus Series 4 to track your healthy habits.
For more information and to schedule a meeting with Appian at HIMSS, contact Appian
Visit Booth 6158 to learn about the offerings of our newest sponsor partner Surescripts. Surescripts will also be sharing information on their products and services in Booth’s 9100-44 and VHQ8659
Other HCEG Sponsors & Partners at 2019 HIMSS Conference
In addition to the above, our other sponsors and partners will be represented at the 2019 HIMSS Conference & Exhibition in some capacity. Check out their leading healthcare products/services and reach out to them for more information.
Resources to Help Conquer the 2019 HIMSS Conference & Exhibition
This year, HIMSS will be live-streaming a number of sessions. Whether you’re attending or not, consider checking out these live-streamed sessions.
Learn more about the companies exhibiting at the conference here. Also, HIMSS has a comprehensive list of all the vendor/exhibitor categories and subcategories to help you refine your list of must-see vendors and exhibitors.
Popular Hashtags at the 2019 HIMSS Conference & Exhibition
Whether you’re attending the 2019 HIMSS Conference or not, you can stay connected with the popular themes and topics – and general HIMSS19 subject by using the following hashtags:
#HIMSS19 = The official hashtag for the 2019 HIMSS Conference
Keep your eyes peeled for more information, insight, and ideas that HCEG members, sponsor partners, and advisors will be gathering from Orlando this coming week. A special ‘HIMSS19-edition’ eNewsletter will be shared later next week including major takeaways, insights from conference thought leaders and some pictures capturing HCEG member and sponsor partners experiences at the conference. If you aren’t already a subscriber to our newsletter, you can sign up here.
Save the Date – 2019 HCEG Annual Forum – Boston, MA
HCEG’s 2019 Annual Forum takes place in Boston, Massachusetts on September 9 – 11, 2019. We’re working on developing an interesting agenda and lining up some great speakers. To learn a bit about last year’s annual forum and see some pictures, check out this recap. And click here to be added to a list to receive the latest information on our 2019 Annual Forum as it becomes available.
It’s no surprise to anyone working in healthcare that healthcare consumerism and digitally enabled organizations that support healthcare consumers and patients are top of mind for today’s healthcare executive leadership. Indeed, Total Consumer Health and The Digital Healthcare Organization are ranked #2 and #5 respectively on the 2019 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare executives.
Topics Discussed at HCEG’s Recent Executive Leadership Roundtable in Nashville, TN
As is the approach with all ELR’s hosted by the HealthCare Executive Group, the theme presented and the topics were aligned with and built upon the theme of the anchor event: Consumer Experience & Digital Health:
Catalysts for Healthcare Consumerism
Turning Passive Health Plan Members and Patients into Active Consumers
How Value-Based Relationships Change How Healthcare Stakeholders Engage with Their Members and Patients
Independence Blue Cross and JP Morgan Chase Perspectives on Member Engagement
Impact of New Competition and Innovations on “Healthcare Consumerism”
This is the first post of a two-part series recapping the information, insight, and ideas shared during the nearly three-hour long executive leadership roundtable event held on December 13th, 2018.
Helping Simplify Healthcare Decisions
One theme throughout the 2018 AHIP CDF was that most compelling opportunities to improve healthcare lie in making the complex simple. In healthcare, there are simply too many transactions that add friction and create misery for the very people who can ill-afford to experience them. These transactions must be imbued with both humanity & simplicity.
Ferris Taylor kicked off the discussion by asking panelists:
What is being done now or can be done soon to help people understand their healthcare options?
Brian Lobley noted the importance and value of healthcare consumers working with and through their PCP or other physician(s) primarily responsible for providing their care. He noted that many primary care physicians will only work within their own healthcare system and will often not suggest any services from other providers outside that healthcare system – even if it were in the patient’s best interest clinically and/or financially. Brian went on to state that until consumers bear more of the cost there will not likely be any appreciable change
Discussion ensued that short benefit periods preclude most health plans or other risk-bearing organizations from investing in people’s health. Everyone seemed to agree that longer benefit periods or some way of sharing individual healthcare costs over a period of multiple years and perhaps across multiple payers would go a long way toward improving individual outcomes and lowering overall costs.
Integrating Services into Physician Workflow and Patient Life Flow
Roundtable participates agreed that in order to maximize consumer and patient benefit and to minimize physician burnout, diagnostic and therapeutic procedures must be intelligently integrated into physician/clinician workflow and the patient’s life-flow.
Physicians and patients simply don’t want to be told what to do but rather provide and obtain needed services as conveniently as possible and as part of their individual, respective day to day workflow and life-flow. As Ferris stated: ‘Make the right thing the easy thing to do!’
Democratizing Healthcare Decision-Making and Control to Consumers and Patients
“Until healthcare is democratized, it’s going to be very hard for consumers to really take control. Right now, healthcare consumers really don’t have much choice because it’s the employers who choose the health plan and the employers who make all the contracting and payment decisions. Until consumers have more choice and can make more of the primary decisions, there won’t be any major improvement.”
Tipping Points to a Truly Consumer Driven Healthcare Industry
One roundtable participant asked:
“What are your predictions on what the tipping points are that would get us to the truly consumer-driven industry much like retail or other things?”
JP Morgan’s Stuart Hanson stated that consumers and employer groups are fed up and taking action on their own and not waiting for the government or health insurance plans to address high costs and inconsistent outcomes:
“I think we are there now with the current member populations of most health plans. Consumers are fed up. They’re asking their physicians harder questions. They’re challenging how their health plans adjudicate claims. They’re actually reading their EOB’s and trying to understand them. And now employer groups are demanding change.”
“But the industry has not adapted to employer and member demands so that’s why there are employer-driven initiatives like the Comcast-IBX initiative and the Amazon Berkshire Chase consortium that are driving employer-based change.”
Stuart and Brian went on to share information and insight on two nascent employer group consortiums they are each involved with:
The 50/50 joint venture between the parent company of Brian Lobley’s Independence Blue Cross, Independence Health Group, and Comcast.
Healthcare – Particularly Pharmacy – is a Huge and Growing Expense
One participant stated loudly: ‘Drug prices and their outcomes must be addressed!’
Stuart shared that, after salary and facilities (rent), healthcare is the 3rd largest expense for most employers. And that pharmacy is the largest and fastest growing part of overall healthcare expenditures. Brian noted that big pharma, and specialty drugs in particular, will eventually sink U.S. healthcare if pharmacy costs are not addressed soon.
The idea that a single payer or ‘Medicare For All’ movement can solve America’s healthcare crises was floated. Brian noted that many people fail to realize that these approaches are still based on a combined government-private solution and that many of today’s cost and outcomes challenges will not necessarily be fixed.
Increase in Home-based Care – Opening Opportunities for Non-Traditional Providers
As the home becomes more accessible physically and virtually via new technologies like voice, home-based medical and non-medical services provided in the home will help accelerate the tipping point. Brian pointed to the recent purchase of GreatCall by Best Buy and his own company’s partnership with Comcast. There was general agreement that the access that Best Buy’s Geek Squad and Comcast’s CATV installers have to the residential market offer great potential to engage with and influence healthcare consumer behavior.
Questions from Healthcare Leaders Participating in HCEG’s Executive Leadership Roundtable
Our roundtable events are free-flowing discussions and the eventual direction of each roundtable event is often dictated by where attendee interaction takes us. And participants at our ELR did ask questions and participate without being prodded:
Who do you think is the next Kodak in the Healthcare Industry?
ELR participant Dr. Kyra Bobinet, MD asked panelists: ‘Who do you think the next Kodak will be in the healthcare space?’
Stuart responded: “Health plans” and noted how there used to be 100+ BCBS health plans and now there are less than 40.
And Brian added: “Hospitals” and noted that there are way too many beds available and hospital facilities and real estate holdings are huge expenses. And the movement of more home-based care is only exacerbating this shift in care settings.
Where do you see benefit design going to actually support true prevention?
Participant Kristen Valdes, CEO of b.well, raised the topic of more and more employer groups wanting to offer preventive and other services that are not often available in many health plan benefit packages. Kristen shared:
‘We are seeing employers in our market wanting to pay for true prevention and we’re having to create programs. Employers are willing to pay (for preventive services) outside of their medical benefit.’
Kristen also noted that more healthcare organizations are offering their members and patients the opportunity to undergo genetic testing as part of a routine primary care visit. Increasingly, analytics are able to interpret these test results in terms of identifying the total cost of an individual based on providing care or not providing care.
The vision is that these services will provide physicians with relevant information to inform personalized treatment decisions for their patients, such as offering preventive steps to patients at risk for hereditary conditions.
Brian Lobley shared his opinion that the healthcare industry is a ways away from more widespread use of genomic and related testing because many individuals are afraid to use these tests based on a fear that the results may be used against them. Several participants shared that they find it hard to believe that someone will allow themselves to be exposed in terms of what their genomic testing reveals about their potential cost of care.
Why Have Health Plans, Physicians and Provider Organizations Not Partnered to Go Against Big Food?
Cate McConnell, Healthcare Change Leader at Appian, questioned why traditional healthcare constituents have not organized to lobby and make attempts to change the negative effect that many of the foods consumed in America have on an individual’s healthcare.
While no one offered an explanation, one participant did reference a recent article claiming that ‘gut health’ can be more important than ‘heart health.’ And Dr. Kyra Bobinet shared that nutrition and proper food choices are her passion and that anyone interested in learning more could reach out to her for more information.
Your Disease Does Not Define Who You Are
To illustrate the importance of how most people view their healthcare status and need, Ferris Taylor shared a description of one’s healthcare state does not define them:
“My wife has diabetes but she isn’t a diabetic. She’s a mother. She’s a grandmother. She sings in a choir. She has a life. She’s in the community. She wants to deal with that one element of her life but get on with all the rest of her life.”
The Four Constituents of Well-Being
In response to Ferris’s share that the state of our health does not define who we are as individuals, Dr. Kyra Bobinet shared that scientific studies have shown that four primary constituents rooted in neural circuits have a significant influence on our well-being:
Resilience: the rapidity with which we recover from adversity; some people recover slowly and other people recover more quickly.
Outlook: the ability to see the positive in others, the ability to savor positive experiences, the ability to see another human being as a human being who has innate basic goodness.
Attention: the ability to voluntarily bring back a wandering attention over and over again is the very root of judgment, character, and will.
Generosity: altruistic behavior activates circuits in the brain that are key to fostering well-being.
Kyra shared that practicing these four skills can provide the substrate for enduring change, which can help to promote higher levels of well-being in our lives. Turns out, well-being is a skill that can be practiced and strengthened.
More About Healthcare Consumerism & Digitally Enabled Organizations
In the second post recapping our Executive Leadership Roundtable, we’ll share insight and ideas on the following topics that were presented and discussed:
How social determinants of health are becoming a driver of consumer health business objectives
Three steps for jump starting digital transformation
What was not addressed at the AHIP CDF that participants thought should have been addressed
ELR participant responses to certain statements and claims during the AHIP CDF
The 2018 HealthCare Executive Group Annual Forum celebrating our 30th-anniversary serving healthcare executives and industry leaders kicks off Wednesday, September 12th at the Hewing Hotel in Minneapolis, MN – the #1 Healthiest City in the United States. The HealthCare Executive Group (HCEG) has the following planned for the 125+ healthcare executives, thought leaders and industry leaders who will participate in the two and half day forum.
Keynotes from Healthcare Industry Executive Leaders
On Wednesday at noon, Andy Slavitt, Former Acting CMS Administrator and current leader of Town Hall Ventures, provides the opening keynote and is expected to share his unique insight about the uncertainty in today’s healthcare environment and where he sees progress being made.
Thursday evening, Dr. Craig Samitt, just days into his new role as President & CEO of BCBS of Minnesota, shares his insight on the current state of health care: “A Seasoned CEO’s Perspectives on Where Healthcare is at and the Challenges and Opportunities Ahead.”
Each of the above keynotes will be provided while annual forum participants enjoy what’s expected to be a delightful breakfast, lunch and dinner service presented by Hewing Hotel staff.
Connect Personally, Professionally and Productively Build Long-Term Relationships
Nine Interactive Sessions for Healthcare Executives
Annual forum participants will benefit from nine interactive sessions covering topics selected and developed by HCEG leadership, session moderators and panelist participants. Each of these sessions are intended to provide actionable insight into current topics of value to the health plan, health system and healthcare provider executives attending our annual forum.
“Payer/Provider Partnerships & Opportunities for the Future”
Are health plans, providers and/or consumers equally prepared for the transformation of healthcare that is underway? Compelling health insurance products are being launched today, based on an expectation of a closer partnership involving clinical and financial changes, enhanced member experience, and market transitions that a multi-system approach typically cannot provide. Hear what payers and providers are doing and how technology is the key enabler.
Tom Howard – Moderator (Payer Division Partner at Cumberland Consulting Group)
Joe O’Hara (Director of ACO Solutions at Horizon BCBS of NJ)
Dr. Matt Hoffman, MD (Chief Medical Informatics Officer at Utah Health Information Network)
“Value-Based Payment & Implications for Healthcare Stakeholders”
Medical device and pharmaceutical companies are looking at new business models as demands to focus on rising costs are made by consumers and government agencies. Hear what companies are actually doing in the movement toward ‘Outcomes-based’ reimbursement. Gain new insights on why value-based payment and pharmacy costs have been HCEG Top 10 items over the last few years.
Jorie Soskin (Value-based Investments at Medtronics)
Other panelists currently being formally engaged
“Chronic Care and Challenges Dealing with High-Cost, Multiple Morbidity Patients”
Panelists will present their experience, insight, and opportunities for using clinical measurement and metrics, payer-provider transparency and clinical improvement to improve outcomes and lower costs for individuals having chronic, co-morbid conditions.
Eric Hamborg (Chief Customer & Revenue Officer at MOBE)
Invited (Chief Medical Officer at Major Health Plan)
“Health & Behavior Change at the Community Level”
Community engagement, efficacy, and empowerment are keys to communities being able to adopt and sustain new behaviors. Panelists will discuss current approaches and strategies to integrate community mobilization and activities more effectively with conventional healthcare strategies, aimed at individual behavior change. Audited results will be shared and discussed as to impact and future implications.
Ben Leedle – Moderator (President, CEO & Board Director at Blue Zones, LLC)
Melissa Lyon, MPH (Public Health Director at Erie County Dept of Health)
Mike Gold (Immediate Past CEO at HMSA – BCBS Hawaii)
Mike Riley (Chief Strategy Officer Naples Community Healthcare System)
Clay Marsh, MD (VP & Executive Dean for Health Sciences West Virginia University)
“Healthcare Single Point of Workflow on Social Determinants of Health”
Focus on the social determinants of health is no longer a sideline conversation and needs a whole new framework of thinking. The reality is SDOH programs are in everyone’s self-interest and there are ways to effectively focus and coordinate efforts for everyone’s benefit. Hear what health plans and provider groups are doing to change the common perspective of SDOH being a public good with limited medical impact.
Brenda Schmidt (Founder & CEO of Solera Health)
Additional session participants are being engaged
“Health Plan Diversification: What does it Mean?”
Panelists share the challenges and opportunities for health plans, health systems, and hospitals to diversify beyond their traditional offerings and the financial, clinical and operational implications of those decisions.
Ian Gordon – Moderator (SVP Health Plan Operations at Regence BCBS)
Tom Vanderheyden (EVP & President of National Solutions at BCBS of MN)
Chuck Divita (EVP Commercial Markets & CFO at BCBS of FL/GuideWell)
Brandon Cady (President & CEO of AIM Specialty Health – Anthem Subsidiary)
“Vision and Perspective for Healthcare from a Washington, DC Perspective”
We’re working to engage the leader of a nationally recognized healthcare association to share insight on the current state of affairs from a Washington, DC perspective.
“Is Block Chain and/or AI in Healthcare’s Future?”
Blockchain and artificial intelligence technologies are catalyzing the pace of innovation and introducing radical shifts that WILL change the business of healthcare. This panel of experts will discuss the potentialities realized at the intersection of AI and Blockchain and the challenges and benefits healthcare executives must understand to not be disrupted by game-changing technologies.
Alan Abramson – Moderator (Senior VP & CIO HealthPartners)
Emily Vaughn (Product Development Director at Change Healthcare)
Justin Adams (CEO at Digitize.AI)
“Technology: From Start to Scale”
Leading healthcare visionaries share their unique insight on the key opportunities and challenges facing healthcare incumbents, especially with potential new market entrants that intend to disrupt healthcare. Is it time to partner or compete with them and how to get to scale the fastest?
Justin Roth – Moderator (Managing Director at TripleTree)
Other panelists are being engaged
A Few Surprises for Participants are Likely!
We’re working on a couple other bits and pieces that we think will be valuable to healthcare executives, industry leaders and others working to advance healthcare in the United States. Unlike most other healthcare conferences that lock down their speakers and content a year – or even more – in advance, we’re focused on bringing the most current, insightful and actionable information, ideas and opinions to our members and forum participants!
Voting and Ranking the 2019 HCEG Top 10 List
Over the last decade, a highlight of the HealthCare Executive Group’s annual forum is the development of the HCEG Top 10 list of challenges, issues, and opportunities that healthcare executives are currently facing. Starting with a list of approximately 25-30 items identified by HCEG members and sponsor partners, forum participants interact with each other to identify the top 10 challenges, issues and opportunities their organizations are facing. After interactive discussion in a roundtable format, the participants rank the items to create the 2019 HCEG Top 10 list.
A new approach this year is that candidates for the HCEG Top 10 list will be reviewed in a roundtable format facilitated by key sponsor partner thought leaders. The objective of the luncheon roundtable discussions will be to clarify the list of challenges, issues, and opportunities facing healthcare executives. Participants can add critical items that may have been missed and have an opportunity for deeper insight into the critical issues for the coming year. The final list of items will then be ranked by forum participants and formally shared with attendees prior to Thursday nights dinner. HCEG Executive Director Ferris Taylor and Chris Link, Sr Consultant at Change Healthcare, will orchestrate the process with assistance from HCEG support staff.
Breakfast, Lunch, and Dinner – Supporting Opportunities to Connect
One of the hallmarks of HCEG’s Annual Forum events is the quality of the venue, the opportunity for intimate interaction among other healthcare executives, and well-planned food, beverage and entertainment accompaniments. Participants can expect to enjoy the following:
Welcome Reception Tuesday Evening
Lunch on Wednesday – With a keynote by Andy Slavitt
Offsite Dinner Reception on Wednesday
Breakfast on Thursday – With a keynote by Dan Buettner
Lunch on Thursday
Dinner + Closing Keynote on Thursday – With a keynote by Dr. Craig Samitt
Nightcap + Winddown on Thursday
Breakfast + Farewell on Friday
Special Executive Leadership Roundtable
In celebration of our 30th Anniversary, the HealthCare Executive Group is hosting a special Executive Leadership Roundtable on Friday, September 14th. Dan Buettner will present “The Blue Zones of Happiness: ‘Lessons from the World’s Happiest People’” during a special Friday morning breakfast event starting at 7:30am. Dan’s presentation will build on and provide additional color and clarity from his “Blue Zones: The Making of a Healthy City” presentation shared the day before.
This event requires individual registration and is limited to executives from health plans, health system, health care providers and local employer organizations. Contact us if you have any questions.