Recapping the 2018 HLTH Future of Healthcare Forum

By | Conferences, HLTH, Executive Leadership Roundtable | One Comment

Photo Credit: HLTH.co

The inaugural 2018 HTLH Future of Healthcare forum took place in Las Vegas earlier this month with 3,500+ attendees and 375+ speakers assembled over four days starting May 5th with the HLTH Hackathon. And HealthCare Executive Group (HCEG) members and sponsor partners were there – interpreting and absorbing key takeaways, presenting as speakers and panelists in various sessions and adding their own unique support and participation at this highly touted, new healthcare conference billed by organizers as ‘The Hottest, Newest, Largest and Most Important Healthcare Event.”

HCEG was also honored to co-host a special HCEG Executive Leadership Roundtable – Leadership, Trust and Skills in Overcoming Obstacles to Radical Innovation in Healthcare – in conjunction with the International Association of Innovation Professionals (IAOIP), the Center for Healthcare Innovation (CHI) and the Workgroup for Electronic Data Interchange (WEDI) and special guest, Dr. Sunnie Giles the author of “The New Science of Radical Innovation.” This three-hour roundtable took place on the last day of the forum as part of HLTH’s Association Day.

Un-Common Content with a Few Common Themes

Sessions at HLTH were organized into five tracks that varied each day. So, with 100+ sessions over four days, there were about 4 or 5 sessions covering any particular track – a reasonable and manageable number. HLTH event organizers also assigned all sessions in each track to the same room location; making it easy to navigate between tracks and sessions. There were a few crowded sessions and some rather sparsely populated sessions.

Based on an informal survey of sessions attended by HCEG members and a scan of various recaps of the HLTH Future of HealthCare forum over the past two weeks, a few common threads emerged.

Must Address Multiple Conditions, High-Cost Patients & Care Transition

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.

Health Happens Outside the Exam Room & Hospital

And many of these same sessions and more than a few of the exhibitors shared information, ideas and approaches aimed at addressing these three populations by focusing on social determinants of health. 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.

As noted in the recent Industry Pulse Research Survey co-authored with HCEG sponsor Change Healthcare, payers are beginning to integrate community programs and resources into their medical practices.  Only 18.9% of responders said they were not currently integrating any social determinants of health, a dramatic change over the last few years.

Payment Innovation in Healthcare is Desperately Needed

Another oft-mentioned topic at the HLTH forum was value-based care and the need for payers and providers to come together on sharing not only upside risk but downside risk as well. While the rise of personalized medicine, targeted therapies, specialty pharmaceuticals and molecular diagnostics offer tremendous opportunity, payers are still growing their sea legs figuring out how to measure outcomes and associated value models – at the same time as providers and the healthcare supply-side are beginning to demonstrate outcome values in risk-based payment contracts.

What’s clear is that rapidly evolving medical technologies must be simultaneously supported by reasonable regulatory frameworks and payment model development. Hopefully, the federal government will serve as the vanguard for innovation in the area of reimbursement.

Engagement: The Most Un-Buzzworthy Word at HLTH?

In one session, the moderator quizzed the panel as to what industry buzzword they disliked most and ‘engagement’ was the clear winner (loser?) among panelists as the most over-used and unclear healthcare buzzword. The CEO of Maestro Health, Rob Butler suggested that people don’t want engagement with a medical condition but rather to be connected to their health system and support networks.

Amanda Natvidad of FitBit noted in her post titled “HLTH Recap: 6 Key Takeaways from The Future of Healthcare Event” that Kimon Angelides, founder and CEO of Vivante Health, suggested, “People with chronic conditions don’t want to be more engaged with their disease – they want to reduce the hassles and be more empowered… and technology can help in this journey.” 

This very idea that People Don’t Want to Be Engaged with their Medical Condition was offered by HCEG Executive Director Ferris Taylor in a recent webinar on the 2018 HCEG Top 10.

HCEG Members & Sponsors at the HLTH Future of Healthcare Forum

More than a few of our HCEG sponsor partners were at the HLTH event – speaking in sessions, as sponsors, participating in 1:1 and small group meetings and exhibiting.

Softheon was active in several ways with sponsoring the HACK/HLTH ‘hackathon’ where participants collaborated and created meaningful solutions in competition for over $80,000 in prizes. Eugene Sayan, Softheon’s CEO also presented ‘Convergence of Health and Non-Health Data’ along with Jeff Margolis, CEO of WellTok.

Not to stop with those two events, Softheon also joined Lyft to sponsor Wyclef Jean at the JEWEL Nightclub on Tuesday. Softheon also was one of the larger exhibitors at the HLTH Future of Healthcare forum. Check out pictures of HLTH’s After-Hours Activities here.

Change in Healthcare at the HLTH Future of Healthcare Forum

Change Healthcare’s President and CEO Neil de Crescenzo keynoted Tuesday’s General Session “The Patient Experience: Making it Easier for Healthcare Providers to Make it Easier” and shared some common-sense solutions to revolutionize patient experiences, utilizing healthcare data in ways which enable providers to orchestrate and improve patient interactions – all while delivering a seamless experience aimed at improving patient loyalty and new patient attraction.

Change Healthcare was also a major sponsor, giving the first 3,000 attendees a high quality hot/cold mug and having a dominant position in the Exhibit Hall.  Change HC also teamed up with Adobe and Microsoft to “Put the ‘Consumer’ in Healthcare Consumer Engagement.”  enable health systems to better engage with patients. The joint solution will use Change Healthcare’s Intelligent Healthcare Network, Adobe’s Experience Cloud, and Microsoft’s Azure offering to improve customers’ healthcare experience. You can learn more about this venture here.

CareCentrix CEO John P. Driscoll was a panelist along with David Muhlestein, Chief Research Officer at Leavitt Partners on a Tuesday session titled ‘Aligning Health Policy to Health Possibility.’ This session addressed the potential for technology to transform the health industry through more innovative – and perhaps disruptive – health policy. There were a few moments of ‘extreme interaction’ between the two panelists.

HealthEdge sponsored one of the few handfuls of ‘Meeting Pods’ at the HLTH event. These small group meeting spaces along the hallways seemed like a good idea and through focused effort, HealthEdge had it pod occupied to clients and prospects during the entire HLTH event.

Announcements at HLTH2018 – Large, Small & Mostly Meaningful

One of the interesting media related events at the HLTH event was the “Make an Announcement” opportunity for all HLTH attendees. All sponsors, exhibitors, speakers or otherwise were able to make an announcement about new products, venture funds being launched, collaborations and other ‘newsworthy events’ at a pre-arranged time in a dedicated media area. Some of the major announcements included:

Former CMS Administrator Andy Slavitt’s new venture firm, Town Hall focusing attention on businesses working to serve the underserved communities across the country. 

David T. Feinberg, M.D., CEO of Geisinger Health announced their commitment to anticipatory medicine and precision medicine initiatives by adding DNA sequencing to routine patient care. 

HCEG’s Executive Director Ferris Taylor also announced HCEG’s 30th Year Anniversary and the opening of registration for HCEG’s Annual Forum on September 12-14th in Minneapolis, MN.

Check out more announcements here.

Interesting Aspects of HLTH’s Future of Healthcare Forum

There were some interesting meeting and networking opportunities at of the HLTH Future of Healthcare event including:

Hosted Buyers Meetings – Rumor was that almost 1000 pre-arranged attendee-exhibitor buyer meetings took place over TBD days at the HLTH forum. https://hlth2018.com/hosted-buyer-program/

Funding Founders – 6 Minute, Double Opt-In VC ‘speed dating/networking session’ took place about 300 times early in the day for one hour. Based on the early morning start time and lively attendance, the Hosted Buyer and Funding Founders sessions seemed like worthwhile features of the HLTH forum.

Great Meal Service – The HLTH organizers offered a nice selection of good food, well-orchestrated for a conference of this size

Digital Content Delivery, Networking and Logistical Support at the HLTH2018 Forum

In a future post we’ll share some insight and opinion about some of the unique ways in which the HLTH Future of Healthcare Forum organizers differentiated their forum and provided extra value opportunities to attendees.

HLTH 2018 Association Day: Executive Leadership Roundtable – HCEG, CHI, IAIOP and WEDI

As noted above, HCEG was honored to join other associations in an Executive Leadership Roundtable (ELR) as part HLTH’s 2018 Association Day. The theme of the ELR was centered on leadership in healthcare innovation and complimented by author Dr. Sunnie Giles highlighting her just published book on “The New Science of Radical Innovation.” Look for a recap of the roundtable as part of HLTH’s Association Day in a following post.

Ongoing Press Coverage of the 2018 HLTH Future of Healthcare Forum

Given that it’s been a couple weeks since the HLTH Future of Healthcare forum has ended, you can imagine there are a number of other recaps like this one from The HealthCare Executive Group. Here are additional recaps of the HLTH Future of Forum currently available:

Looking back at HLTH 2018

Startup Health chief on investment strategies, getting out of healthcare’s bubble

What the HLTH?

At HLTH, David Feinberg, M.D. Shares Why Geisinger Is Investing in the Full Health of Its Communities

Are Federal Health Officials Fed Up with Providers’ Unwillingness to Take on Downside Risk?

At the HLTH Conference, Former CMMI Director Patrick Conway Looks Back, and Forward

At HLTH, a Candid Discussion of What the Federal Government Can and Should Do to Promote Healthcare Innovation

Digital Health Innovators are Setting their Sights on Medicaid—Can the Private Sector Improve Healthcare?

Walmart’s next healthcare move: Using data to identify bad doctors

Closing Out the First-Ever HLTH Meeting in Las Vegas

HLTH & Healthcare — My tweetstorm on the HLTH conference

HLTH The Future of Healthcare – Convening, Collaborating, and Curating – Or, Do We Really Need Another Conference?

HLTH Recap #1: Kicking It Off

HLTH Recap #2: Making It Real

HLTH Recap #3: Top Picks

Readers Write: HLTH 2018 Recap: A Transformation in Talking about Healthcare Transportation

HLTH Recap: 6 Key Takeaways from The Future of Healthcare Event

Live at HLTH, Trevor and Steve host a Unicorn Panel with Frank Williams, Anne Wojcicki and Jonathan Bush.

DIGITAL HEALTH BRIEFING: HLTH conference roundup

More Insight and Ideas on Events for Healthcare Executives

Check back soon for more on the 2018 HLTH Future of Healthcare Forum. We’ll provide a detailed recap of the Executive Leadership Roundtable event that took place on Wednesday, May 9th.

Before the month is out, the HealthCare Executive Group will be opening up registration for our Annual Forum taking place in Minneapolis, MN on September 12 – 14th.  We have a special event planned to celebrate our 30th year anniversary. If you’re a healthcare executive who can benefit from collaborating with your C-suite peers, consider becoming a HCEG member.

In the meantime, be sure to follow us on Twitter, Connect with us on LinkedIn and subscribe to our eNewsletter.

Population Health, Value-Based Care, & The Engaged Digital Consumer – An Executive Leadership RoundTable

By | Events, Partners | No Comments

On the 2018 HCEG Top 10 list, Clinical and Data Analytics, Value-based Payments and The Engaged Digital Consumer were ranked #1, #3 and #10 respectively by health plan, health system and healthcare provider executives who participated in identifying and ranking the 2018 HCEG Top 10. It seems fair to say that these three topics are front and center on the mind of executives and thought leaders in the healthcare industry.

Leverage Your AHIP Event & Nashville Connection

If you’re attending AHIP’s 2017 Consumer Experience & Digital Health Forum in Nashville or if you’re a healthcare leader in Nashville the afternoon of Thursday, December 7th, consider joining other healthcare executives and thought leaders at our Executive Leadership Roundtable. A panel of prominent healthcare leaders will meet at Nashville’s Center for Medical Interoperability at 1:00pm CT to accelerate the seamless exchange of information to improve healthcare for all by exploring emerging and high-priority healthcare opportunities at the intersection of population health, value based care, and the engaged digital consumer.

Join Healthcare Leaders & Forum Attendees in a Boardroom-like Setting

HCEG Executive Leadership Roundtable events are held in an intimate, informal and free-flowing setting where the free exchange of ideas, questions and comments are encouraged. This roundtable event will be moderated by Dr. David Diloreto with three distinguished panelists sharing their unique perspective and insight:

Dr. David DiloretoBen LeedleFerris TaylorDavid Gallegos
Senior VP of Healthcare-Population Health at General ElectricPresident & CEO at Blue Zones and former President & CEO of HealthwaysHCEG Board Chair and COO/Consultant at Arches Health PlanSenior VP of Consulting Services at Change Healthcare

Timely Topics for Healthcare Leaders

A timely and valuable set of topics – with a special focus on Social Determinants and Clinical Data Impacting Population Health – are planned for panelists and attendees:

  • Innovative strategies health plans, health systems and provider organizations are using to reduce downstream spending while improving overall health outcomes by addressing social determinants of health.
  • How state-of-the-art data and technologies and opening new opportunities to move consumer health forward.
  • Opportunities to work with community leaders to identify the factors having the most influence on individual health and quality of life.
  • Considerations for tailoring specific approaches and investment to address the needs of health plan members and healthcare patients in their communities.
  • How ground-level community stakeholders can guide health plans and health systems to where funding creates the most effective SDOH improvements.

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

In addition to the value described above, this Executive Leadership Roundtable event will include a tour of the Center for Medical Interoperability, lunch and the opportunity for professional networking with roundtable panelists and participants. The Center for Medical Interoperability is a ten-minute ride from the AHIP Consumer Experience & Digital Health Forum being held at the Music City Center in Nashville, TN.

Reserve Your Seat Today!

Attendance at the roundtable is free for current and former HCEG members, attendees of the AHIP Consumer Experience & Digital Health Forum and local healthcare executives.  If you have any questions, please contact us.

Healthcare Executive Leadership Forum at Guidewell Innovation Center

HCEG Attends the 2017 Healthcare Summit & CMA Celebration in Nashville

By | Events, Partners | No Comments

Source: emids

After helping host the 29th Annual Forum of the HealthCare Executive Group held last September in Nashville, our board chair Ferris Taylor returned to Nashville last week to attend emids 2017 Healthcare Summit & CMA Celebration. And if those two trips to Nashville weren’t enough, HCEG will be returning to Nashville to host one of our Executive Leadership Roundtable events on Thursday, December 7th – immediately following AHIP’s 2017 Consumer Experience & Digital Health Forum. Nashville really does live up to its moniker of “The Healthcare Management Capital of the United States.”

More About the 2017 Healthcare Summit & CMA Celebration

The 4th Annual Healthcare Summit & CMA Celebration sponsored by emids was an invitation-only event that brought together CEOs and leading executives from the healthcare industry to discuss how they are balancing provider, payer and patient accountability to provide more value and better outcomes for the future healthcare consumer. In this post, we’ll share a short recap of the summit proceedings and set the stage for a following post where we’ll share specific information, ideas and opinions from four panels moderated by industry leaders Justin Roth of TripleTree Investments, Russ Thomas of Availity, Dr Emad Rizk of Verscend and Glen Tullman of Livongo.

Dominant Themes at the Summit

Summit keynotes and sessions addressed opportunities, challenges and issues that healthcare executives and industry leaders must individually and collectively address during this period of uncertain reform and digital transformation of the healthcare industry. These included:

Impact and Continued Entrance of “Outsiders”

There are a whole bunch of companies outside of healthcare looking at the industry and saying, “We can do it better!”  Tomorrow’s healthcare innovations may very well come from outside of the industry… not just Amazon, Google, Lyft, Nike, Apple, etc.… but even other firms likely germinating in someone’s garage or one of the seeming 100’s of accelerators, incubators, or co-working spaces.

Importance of Data Liquidity and Exchange

Click for more info

Data and strategies for using data to drive new modes of thinking for the entire ecosystem of healthcare were a common point of discussion. Advances in artificial intelligence and machine-learning algorithms that tap into unstructured data were a promising area widely discussed.

Engaging Healthcare Consumers & Patients

Just as successful innovations for providers need to fit into their existing “workflow,” consumer solutions need to fit into the consumer’s “Life Flow.”  Consumers don’t want to be more engaged with their chronic conditions – they want to address their chronic conditions and get more engaged in living their lives.

Trust Among All Healthcare Constituents

All healthcare stakeholders – health plan members, patients, providers, and payers must work toward addressing the “trust” issue.  Consumers don’t necessarily care about how much you know as much as how much you care.

Source: emids

Come Back for More – And Going Back to Nashville

Be sure to check back for our next post where we’ll share information gleaned from the four panels presenting at the summit. And more about HCEG’s return to Nashville in December for our Executive Leadership Roundtable and how you can join other healthcare leaders after the AHIP Consumer Experience & Digital Health Forum on Thursday, December 7th.

In the meantime, consider connecting with us on our social channels: Twitter, LinkedIn and Facebook. And subscribe to our eNewsletter so we can push worthwhile information to you on a regular basis.

Healthcare Executive Group Supports National Health IT Week – October 2-6, 2017

By | Events, HCEG Top 10, Partners | No Comments

NHITWeek National Health IT Week HealthIT healthtech HIMSS HCEGToday 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.

For more information on the 2018 HCEG Top 10, see today’s press release and visit our web site.

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 #NHITWeek hash 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.

Part 2 of Health System & Health Plan Innovation, Change & Growth During Uncertain Times

By | AHIP, Payers, Health Literacy, Healthcare Policy, Waste & Abuse | No Comments

health systems health plans focus for 2017 health reform outcome literacy members consumers #HITsmIn Part 1 of this series of posts, we shared some insight, ideas and opinions on the first of six topics shared in last week’s Health Information Technology Social Media (#HITsm) tweetchat Health System & Health Plan Innovation, Change & Growth During Uncertain Times.” A total of 72 participants tweeted over 650 times in the chat co-hosted by the Healthcare Executive Group, @_GWConnect and @_GuideWell.

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.

Insight, Ideas and Opinions on Topic #2

Connect with Members, Consumers & Patients

  1. Create a connection with the patient that goes beyond the office visit.
  2. Identify, understand & work with ‘impactable members’ to help them make good, cost-effective decisions about their healthcare.
  3. Health systems & plans need to engage w/ patients & members on a more meaningful & regular basis. Not just via EOB’s.
  4. Find out what’s going on in patients’ homes and determine the services they need to keep them healthy.
  5. Include the patient in everything – from the patient’s own care to the growth of the health plan/system. Act on what they hear.
  6. This’s the ‘Hatched, Matched & Dispatched’ cycle. Health plans only ‘engage’ at enrollment, w/ claim EOB’s & at termination.

Address Waste & Abuse

  1. At #AHIPInstitute, Eric Topol said ‘75% of top 10 high cost drugs are prescribed to non-responding patients.” STOP the waste!
  2. Waste and overtreatment, heard from @DocLazris #ErikRifkin are on a mission against it. Video here: https://t.co/OvfS9zjFAW
  3. IMHO it’s important to educate people about how to use their insurance effectively to control their costs. Price Transparency too

Help Consumers Become Better Patients

  1. Focus must be on enable patients to take control of their own care and to be more involved through easy integration of tech.
  2. Universal language – like, “Do you accept my health plan?” Simple question but so often answered wrong.
  3. When these languages are translated into HIT, all those stakeholders interpret associated rules & allowances differently
  4. If you adopt universal languages, IMHO, you will see some of these issues disappear or at least some clarity enter
  5. Smaller, more often, more meaningful. I have to write stuff that’s specific, timely, and actionable – why does H/C bury me in dross?
  6. Anthem has a monthly health plan summary to members that contains ‘personalized and actionable’ health & wellness insights.
  7. “Self-Care Shows Promise In Keeping Individuals w/ Behavioral Health Needs Out of the ER” – Video here: https://t.co/y4As4wkwkY

Don’t Ignore the Masses – Invest in Preventive Services

  1. Insurance! Invest now to save later is a motto that not many want to hear but need to have more faith in.
  2. Need to focus on treating the largely ignored ‘healthy people’ to prevent them from becoming the 5% of patients consuming 22%
  3. I am going 2 go there. Inclusion. No high risk pools. The One-Plan Plan. With a focus on prevention and wellness to mitigate risk
  4. We need to start providing preventive treatments to the masses vs. spending lion’s share of resources on the few sick.
  5. Such a good question. I think prevention costs are minimal compared to the other side of heart surgeries or chemo…
  6. I know a plan that’s feeding care gaps to physicians, so they can stay ahead of the gaps. Also helps scheduling.

Focus on Core Mission & Quality

  1. Shedding/outsourcing operations not core to their mission – like moving data centers to the cloud are long overdue.
  2. All #healthcare needs to focus on quality of care, especially since value-based care and payments look like they will stay

Smartphones – Everyone Has One – Leverage Them!

  1. IMO, health systems & plans must enable consumers and patients to use those things they’re always staring at: Smartphones.
  2. Our President Dr Rene Lerer suggests smartphones will be the “most important part of your body” for health

Interoperability

  1. No matter the #ACA result, plans and providers must get along, and have systems/infrastructure to enable real-time data exchange.
  2. Also interoperability among healthcare tech platforms to provide better utilization of collected patient data

More on the Remaining Four Topics Coming Soon

Check back later this coming week to learn what chat participants shared on the remaining four topics:
      T3: Who’s most likely to disrupt healthcare: insiders or outsiders? And what barriers do each face – right now or in near future?
      T4: What technologies will do the most to move healthcare supply-side toward improving outcomes, lowering costs & enhancing equity?
      T5: Incentives drive innovation. How can they be aligned to meaningfully support innovation that improves outcomes & lowers costs?
      Bonus: What are examples of innovative healthcare programs, processes, people and organizations – U.S.-based or elsewhere?

One More Time!

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

For more about opportunities, challenges, and issues impacting healthcare plans, health systems and payers, consider following @HCExecGroup on Twitter and join us on LinkedIn and Facebook too.

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

By | AHIP, Payers, Quality Measures, Healthcare Policy, Holistic Individual Health | No Comments

Healthcare-innovation-change-growth-executives-HCEG

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

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

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

Thanks to Hosts & Participants!

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

Insight, Ideas and Opinions on Topic #1

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

Precision Medicine – aka. Personalized Medicine

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

Patients, Consumers & Health Plan Members

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

Importance of Basic Health Education, Literacy & Preventive Care

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

Customer Relationship Management

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

Data is Critical to Healthcare

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

The Importance of Home & Social Determinants of Health

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

Quality Measures & Measuring Outcomes

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

Look for More on the Other Topics in Following Posts

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

Highlights from Day 1 of 2017 AHIP National Health Policy Conference

By | AHIP, Payers, Delivery System Transformation, Healthcare Policy, Next Generation Payment Models, Value-Based Payment/Care | No Comments

The 2017 AHIP National Health Policy Conference kicked off today in Washington, DC.

Political, business, and health care leaders from across the nation gathered to dive deeply into our nation’s top policy priorities in an effort to move forward in today’s uncertain healthcare environment.

What a period for healthcare reform in the United States!

In addition to some general comments about healthcare policy and politics, today’s sessions addressed topics such as the following:

  • Risk-sharing and Cost Control
  • Value-based Care
  • Pharmacy Costs
  • Medicaid Exchanges
  • Importance of Social Determinants of Health

Social shares from conference attendees

As is happening more and more at many of today’s top healthcare conferences, conference proceedings, insights and other information were shared on Twitter – among other social channels. Here’s a sample of some interesting shares from Day 1 of the 2017 AHIP National Health Policy Conference.

Thanks to all those noted below who took the time to share with those who were unable to attend the conference.

General Stuff

HandleTweet
@ajmc_journalThere’s still a basic misunderstanding of how health insurance works, says @AHIPCoverage’s Tavenner
@rpalme01@MD_Insurance @al_redmer ACA “status quo is not an option, status quo is not a solution”  #ACA
@nancyrwiseNewt Gingrich sure that SOME bill will be passed this session…  but no direction on what it will include.  #AHCA
@nancyrwiseT. Nickel, thank you: “Association Health Plans are awesome… until they are not”  @NAIC_News

Cost of Healthcare & Risk-Sharing

HandleTweet
@ajmc_journalThe only cost containment strategy that works is cost sharing but it can be such a burden that it takes care away–@chipkahn
@avercloudHealthcare payers: Make the move from pilot to full-scale bundled payment adoption. Let’s discuss at #AHIPPolicy
@leah_a_brownThe discussion a few years ago was about coverage, now healthcare 2.0 is about cost.
@mahphealthGood point by MD Comm. Al Redmer Jr on NAIC panel Can’t do anything on premiums unless moderate cost of delivering #healthcare
@nancyrwiseGreat quote: “Pay for value = transferring risk to providers.” M. Chernew
@nancyrwiseIf health orgs are bigger & more integrated, they are better positioned to own market power: unlikely to lower costs. M. Chernew
@suemontgomery2Cost of premiums is all about the cost of delivering care. – Ted Nickel at #AHIPPolicy

Value-based Care & Reimbursement

HandleTweet
@ahipcoverageConsumers want affordable coverage & high-quality care – that’s what value-based care delivers.
@avercloudDebate the policy, but value-based healthcare is here to stay. Let’s discuss bundled payment success at upcoming #AHIPPolicy

Pharmacy

HandleTweet
@springstexPrescription drug costs pass physician services as biggest slice of health insurance premium
@rpalme01Keep talking to your local pharmacist and sharing what he tells you.

Medicaid Exchanges, Access & Importance of Social Determinants of Health

HandleTweet
@ajmc_journalHealthcare reform is a question of access vs true availability. The devil is truly in the details, said @AndyGurmanMD
@nancyrwiseInterested in continuing conversations about potential intersection of #Medicaid and Exchange markets in #healthcare #simplicity
@ahipcoverageFrom transportation, housing & environmental health, plans are addressing social determinants of health

Keep on Top of More Insight on Healthcare Reform

Be sure to follow the Healthcare Executive Group on Twitter, Facebook and LinkedIn where we share insight into the challenges, opportunities and issues facing healthcare executives and others in today’s fast-changing healthcare environment.

The Future of the State Exchanges: Post Election

By | Events, Partners | No Comments

Ferris W. Taylor, HealthCare Executive Group Office of the Chair and Past COO, Arches Health Plan presented “The Future of the State Exchanges: Post Election” at a special pre-conference event of the 2017 American Association of Payers, Administrators & Networks (AAPAN) Annual Forum in Tuscon, AZ on January 28th, 2017.

In his presentation – which can be found here – Ferris shared his real-world experience and perspective on state-based health insurance exchanges and how exchanges in particular and the ACA in general may be impacted in the coming months and years. Ferris admitted that he needed to look into his crystal ball for ‘assistance’ on a few of his thoughts. Some highlights from the presentation and ensuing discussions with forum attendees include:

  1. The ‘Affordable Care Act’ could also have been titled the ‘Accessible Care Act’

Access alone is not enough. The Triple Aim dictates that Access, Cost and Quality must be simultaneously addressed in order for true healthcare reform to be achieved.

  1. State-based Exchanges are better positioned than others

States that implemented their own exchanges are better positioned to respond to any reform approach ultimately decided by the Administration and Congress.

  1. Confidence in the Public Exchange has been falling dramatically year over year

Ferris shared some preliminary results from The Industry Pulse, an annual research survey hosted by Change Healthcare that is based on HCEG’s yearly Top 10 list, and pointed out that the three exchange-related items that actually improved year over year were items within control of health plans:

  1. Direct Sales (Web-based)
  2. Single Payer Private Exchanges
  3. Storefront/Retail
  1. Insurance Market Reform Options and Market Support Considerations

Ferris shared two information-packed slides outlining various health care reform options being floated by President Trump, HHS nominee Tom Price, Speaker Paul Ryan and others – including the  ACA Replacement plan proposed by Bill Cassidy (R-LA) and Susan Collins (R-ME) which would largely give individual states the option to continue operating under existing ACA regulations.

Look closely…that’s a turtle under there!

  1. Trigger Points & Timeline – and Things to Watch

Ferris and the attendees had a lively discussion surrounding key ‘trigger points’ related to healthcare reform and some ‘Things to Watch.’ See the presentation here for more information on these two presentation topics.

Additional Info on Potential Impact to ACA and Health Insurance Exchanges

“Healthcare Triage: Fixing the exchanges”The Incidental Economist@IncidentalEcon

“Milliman identifies six key questions arising from the Trump/ACA executive order” – Milliman @millimaninsight

“What’s Next for U.S. Healthcare Under Trump?”LEK @LEK_Consulting

“President Trump and the Affordable Care Act: What Happens Now?” –  Schulte Roth & Zabel – @SRZLawFirm

Check out the following for more information on:

Ferris W. Taylor

Healthcare Executive Group

Benefits of being an HCEG member

AHIP 2016 Highlights: Top Healthcare Industry Execs Discuss Data Integration Challenges & Discuss Priorities

By | AHIP, Events, Partners

AHIP 2016 was held last week in Las Vegas, NV at the Wynn hotel & casino. It was an excellent turnout from an attendee audience perspective solid representation across payer and provider organizations as well as business and IT participation from departmental manager to CEO and vendor community support. Below are the insights and outcomes of an executive roundtable meeting that discussed data integration challenges and opportunities in healthcare hosted by MarkLogic, a leading operational and transactional Enterprise NoSQL database provider powering numerous healthcare digital transformation projects and data silo integration / aggregation strategic initiatives for payers, providers and health IT vendor platforms.

The following research and information is summarized and de-identified to respect the confidentiality of the executive roundtable audience and their respective organizations. The organizations represented included market leading payers, providers, health IT vendors and consultants. Audience titles ranged vertically from director to CEO and horizontally from clinical, administrative, financial, product, operations and IT functions. The prevailing executive roundtable observation and summary insight, after more than 90 minutes of discussion and debate on individual healthcare industry themes and use cases was that, breaking down data silos and developing an enterprise data layer or hub is fundamental to achieving any one of these strategic initiatives and use cases that are essential to our ability to innovate, modernize and survive.

The executive roundtable topics were sourced in part from the Healthcare Executive Group (www.hceg.org) 2016 Top Ten List (https://hceg.org/hceg-top-ten/) and direct industry field interactions. The HCEG 2016 annual forum is scheduled for September 12-14th in New York City.

While there are many levers to flip and knobs to turn to lead healthcare into the modern era of the new digital health economy, this executive roundtable discussion was primarily focused on the underlying data integration challenges holding back innovation created by decades of departmental purchasing of proprietary, standalone point solutions and developing or implementing applications using rigid relational technologies requiring expensive and resource intensive extract, transform and load (ETL) processes.

The stimulus for the executive roundtable audience provided a categorization of broad healthcare market initiatives shared across geographies and lines of business focused on the strategic themes listed below:

  • Client Management
  • Consumer Engagement & Retention
  • Data Enablement & Infrastructure
  • Network Management
  • Payment & Reimbursement
  • Population Health & Medical Management
  • Quality, Accreditation & Compliance

The executive roundtable audience was asked to score and prioritize the degree of impact and importance data integration has on the strategic themes and initiatives listed above. The response scoring methodology, principles and process leveraged techniques from an acclaimed book on leading innovation called, Nail It then Scale It: The Entrepreneur’s Guide to Creating and Managing Breakthrough Innovation, by Nathan R. Furr and Paul Ahlstrom.

Some typical or common use cases aligned to the strategic themes / initiatives listed above were provided the simulation stimulus into give the executive audience context in their scoring consideration for data integration impact and importance. Use cases included, but were not limed to:

  • Client Management Use Cases
    • Client (group) contract management / search
    • Client (group) onboarding
    • Client (group) premium payments
    • Product & policy administration
  • Consumer Engagement & Retention Use Cases
    • Consumer360 / Vision 2020
    • Member communications
    • Provider search
    • Online enrollment / exchanges
  • Data Enablement & Infrastructure Use Cases
    • Enterprise data layer / digital transformation hub
    • M&A integration
    • Provider interoperability / health system integration
    • Mainframe migration
    • Re-platforming home grown apps (3rd party app conversions)
  • Network Management Use Cases
    • Provider contract management / search (FFS and VBR)
    • Provider network management (enrollment, credentialing, etc)
  • Payment & Reimbursement Use Cases
    • Billing, payments and collections (premiums)
    • Reimbursement (FFS, ACO, VBR, MACRA, etc.)
  • Population Health & Medical Management Use Cases
    • Care management, Disease Management, Utilization Management
    • Risk management / stratification
    • Data analytics / reporting
  • Quality, Accreditation & Compliance Use Cases
    • NCQA accreditation, audit & compliance
    • URAC accreditation, audit & compliance
    • STARS accreditation, audit & compliance
    • HEDIS audit & compliance
    • Fraud, Waste & Abuse and Special Investigations Unit (SIU)

The results of the executive roundtable audience scoring and prioritization the themes and use cases are below. The criteria for a minimum investment for an individual theme or initiative were $20 and the total budget available per audience member was $100. Investment per theme or initiative could be any amount between $20 – $100.

  • #1 Data Enablement
    • Average index score of $42.15 investment contribution
    • High = $50
    • Low = $25
    • Insight: 70% of the audience put some form of investment in this category. This was a high frequency and high average monetary contribution area of priority for data integration.
  • #2 Network Management
    • Average index score of $35.00 investment contribution
    • High = $60
    • Low = $20 (minimum investment)
    • Insight: 25% of the audience put some form of investment in this category. This was a low frequency but high average monetary contribution area of priority for data integration.
  • #3 Consumer Engagement & Retention
    • Average index score of $32.50 investment contribution
    • High = $50
    • Low = $20 (minimum investment)
    • Insight: 90% of the audience put some form of investment in this category. This was a high frequency but average to below average monetary contribution area of priority for data integration.
  • #4 Population Health & Medical Management
    • Average index score of $30.63 investment contribution
    • High = $40
    • Low = $20
    • Insight: 70% of the audience put some form of investment in this category. This was a high frequency but average to below average monetary contribution area of priority for data integration.
  • #5 Payment & Reimbursement
    • Average index score of $30.00 investment contribution
    • High = $40
    • Low = $20
    • Insight: 80% of the audience put some form of investment in this category. This was a high frequency and below average monetary contribution area of priority for data integration.
  • #6 Client Management
    • Average index score of $26.25 investment contribution
    • High = $40
    • Low = $20
    • Insight: 25% of the audience put some form of investment in this category. This was a low frequency and below average monetary contribution area of priority for data integration.
  • #7 Quality, Accreditation & Compliance
    • Average index score of $20.00 investment contribution
    • High = $20
    • Low = $20
    • Insight: 15% of the audience put some form of investment in this category. This was a low frequency and below average monetary contribution area of priority for data integration.

In summary, there was strong agreement among executive roundtable participants that data infrastructure investments and enhancements were needed before additional application, investments and enhancements. To be specific, most executive roundtable participates agreed that their organizations needed an enterprise data foundation that is transactional, not just another static data warehouse, to integrate data across disparate sources and formats to run our business on before organizations could truly improve application performance, utilization and ultimately customer experience and satisfaction.

About MarkLogic

For over a decade, organizations around the world have come to rely on MarkLogic to power their innovative information applications. As the world’s experts at integrating data from silos, Mark Logics operational and transactional Enterprise NoSQL database platform empowers our customers to build next generation applications on a unified, 360-degree view of their data. Headquartered in Silicon Valley, MarkLogic has offices throughout the U.S., Europe, Asia, and Australia. For more information, please visit www.marklogic.com.

MarkLogic is a registered trademark of MarkLogic Corporation in the United States and/or other countries. All other trademarks mentioned are the property of their respective owners.

About HCEG

The HealthCare Executive Group is a national network of select healthcare executives and thought leaders, who navigate the tactical and strategic issues facing organizations today and provide a platform that promotes healthcare innovation and the development of life-long relationships. Originally the Managed Care Executive Group (MCEG), The HealthCare Executive Group (HCEG), was founded in 1988 by healthcare executives looking for a forum where the open exchange of ideas, opportunities for collaboration, and transformational dialogue could freely ensue. For more information, please visit www.hceg.org

Author: Bill Gaynor, Healthcare National Director at MarkLogic Corp.