How Healthcare Executives Leverage HealthCare Executive Groups Top 10 List. HCEG Top 10. Digital transformation. WHCC. World Health Care Congress.

How Healthcare Leaders Leverage the 2019 HCEG Top 10 List

By | HCEG Top 10, Social Determinants of Health, WHCC | No Comments

How has the HealthCare Executive Group’s annual Top 10 list of challenges, issues, and opportunities helped to guide healthcare leaders and their companies over the last decade?

During a break at the 16th Annual World Healthcare Congress held in Washington, DC earlier this month, our Executive Director Ferris Taylor had a chance to talk with Mabel Jong of MJC Communications, LLC. Ferris recounted the story of how members of the HealthCare Executive Group have developed and used our annual ‘Top 10’ list of challenges, issues, and opportunities as a means of to verify, validate, and address their top challenges, issues, and opportunities.

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.

RELATED: Recapping 16th Annual World Health Care Congress & CIO/CTO Strategy Track

Healthcare Leaders Identify Issues, Challenges, & Opportunities

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.

RELATED: The 2019 HCEG Top 10 List of Healthcare Challenges, Issues & Opportunities

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.opioid crisis, opioid management

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.

Ferris: Right

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.”

RELATED: 2019 HCEG Top 10 Infographic

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:HCEG: HealthCare Executive Group. Membership for leadership. Digital health transformation. Annual Forum. HIMSS, AHIP, WHCC, MGMA, CHIME, WEDI, HLTH

  1. Subscribe to our eNewsletter
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  5. Join us in Boston, Massachusetts for 2019 Annual Forum on September 9th-11th, 2019

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Recapping 16th Annual World Health Care Congress & CIO/CTO Strategy Track

By | HCEG Top 10, Partners, Social Determinants of Health, Value-Based Payment/Care, WHCC | 3 Comments

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:

  1. Quality measures that incorporate social determinants of health must be developed and understood BEFORE starting programs and initiatives.
  2. Readily available public data is not granular enough to capture SDoH factors needed appropriate quality measures.
  3. Conducting clinical trials on proposed quality measures can help to understand and quantify the benefits of SDoH initiatives.
  4. Incorporate patient/member personalization into a standardized, common infrastructure that enables economies of scale.
  5. Predictive analytics – a perennially high-ranking item on HCEG’s Top 10 lists – is THE critical component of SDoH programs.
  6. Combining clinical data from EHR’s with claims and other administrative/demographic data records allows health plans/health systems opportunities never before easily attainable.
  7. 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.
  8. Organizations should strive to assign a financial measure assigned to each quality measure.

CIO & CTO Strategy Track at World Health Care Congress

HCEG. Healthcare Executive group. WHCC. World Health Care Congress. CIO & CTO Strategy Track.

HCEG board chair Kim Sinclair, CIO at BMC HealthNet Plan and board member Alan Abramson, Sr VP of IT & CIO at HealthPartners and Co-Chair of the Minnesota eHealth Advisory Committee, shared some real-world examples of how they and their organizations are addressing some of the items on the 2019 HCEG Top 10 list.

Alan Abramson shared four areas of focus for HealthPartners:

  1. Formally chartering projects to deploy technology-based approaches to largely manual processes
  2. Carving out and focusing on efforts to improve patient experience
  3. Address inefficiencies in technology ecosystems, business policy, and processes
  4. 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:

  1. Utilizing Lawson Financials to consolidate multiple disparate functions
  2. Rehosting and re-platforming administration systems such as employer group setup, utilization management reporting, new member enrollment, and patient admission, discharge and transfer.
  3. Positioning systems, policies, and procedures to accommodate increases in individual health plan coverage
  4. Consolidating four different laboratory systems into one system
  5. Using Robotic Process Automation (RPA) to automate user administration and security
  6. Using AI-powered bots to automate 27,000 software QA tests that took three weeks to complete and that now take 17 hours.
  7. Alan noted that achieving success via ‘standardization’ in one area often leads to end users demanding improvement via standardization in other areas.HCEG. Healthcare Executive Group. WHCC. World Health Care Congress. CIO & CTO Strategy Track. Top 10. Industry Pulse

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:

  1. Integrating various systems with a focus on creating an industry-leading accountable care organization (ACO).
  2. Formal projects to identify and stratify members and patients with complex care management needs.
  3. Revising policies, procedures, teams, and systems to effect a truly integrated system.
  4. Reducing pended claims and time to pay – particularly important where both payer and provider are sharing risk.
  5. Focusing on change management and investing in payer-provider interoperability and support.

RELATED: Executives, Policymakers & Thought Leaders Address Healthcare Innovation and Disruption

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.Cybersecurity. WHCC and HCEG HealthCare Executive Group, Tim Thull Medica Health Plan. CIO & CTO Strategy Track

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.

Jothi Dugar, Chief Information Security Officer in the Office of the Director at the NIH Center for Information Technology shared what seems like an obvious approach to thinking about cybersecurity but may not, in fact, be so common:

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 Engram, MSPH from the ReImagine HHS Data Insights Initiative/ACF Office on Trafficking in Persons at Health & Human Services presented the “Optimize Information Sharing to Generate Real Value from Data” session in the CIO & CTO Strategy track.

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.

  1. Data are in silos
  2. Data sharing is inefficient
  3. Analytics capacity is uneven
  4. 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.

WHCC19.Healthcare Executive Group. HCEG. Video Interviews by Mabel Jong. Ferris Taylor, Chief Operating Officer of Arches Health Plan and HCEG’s executive director. HCEG Top 10. Annual Forum.

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:“Keynotes at the 2019 World Health Care Congress went right to the heart of issues impacting healthcare today: transparency, value-based payments, social barriers, member engagement, and affordability

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:

5 Things to Know From World Health Care Congress 2019 – Via AJMC

Unlocking Innovation in Value-Based Care – Via FierceHealthcare

How to speed up the shift from volume to value? – Via FierceHealthcare

How Bright Health is changing the payer-provider dynamic – Via FierceHealthcare

Trump likely to target Medicare in quest for lower drug prices – Via FierceHealthcare

Importance of Process Measures When Determining Value of SDOH Initiatives – Via AJMC

Gottlieb talks about lessons from opioid crisis in first speech since leaving FDA – Via FierceHealthcare

RELATED: Top Tweets from 16th Annual World Health Care Congress – #WHCC19

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.HCEG. Healthcare Executive Group. Annual Forum. Conferences for executives leadership. Events. Eventprofs.

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.

Check out some photos, program guide and presentation materials from last year’s Annual Forum celebrating our 30th anniversary. And visit this page for more information and to register.