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.
The behemoth of all healthcare conferences started today: the 2018 HIMSS Conference & Exhibition. Few healthcare conferences garner the attention of healthcare industry executives and professionals as the annual HIMSS Conference and Exhibition. And HealthCare Executive Group (HCEG) members, sponsor partners and advisors are among the approximate 45,000 healthcare professionals descending upon Las Vegas this week to network with others, attend sessions addressing topics of interest, cut through the clutter and and jockey for position among 10’s of 1000’s of others in the cavernous exhibit halls of the HIMSS conference.
How Big is the HIMSS Conference?
To get an idea about the sheer size of the HIMSS Conference & Exhibition, consider the following statistics provided by HIMSS:
Number of Attendees: Approximately 45,000 people – equal to a capacity crowd during a Cubs game at Wrigley Field
Geography: attendees from 40 countries will be represented.
Exhibitors: About 1300+ vendors – most all of them flush with shiny handouts and branded tchotchke battle each other for the attention, contact information and budget of the attendees from around the globe.
Carpet: More than 10 miles of carpet cover the aisles of the exhibit hall
Connectivity: About 18 miles of cabling provide internet connectivity throughout the convention center.
HCEG’s Top 10 Mirror Popular HIMSS Themes
Historically, industry executives, media, thought leaders, speakers, influencers and brands predict major HIMSS conference themes in the months and weeks leading up to the conference. Not surprisingly, this year’s major themes closing align with the opportunities, challenges and issues ranked by HCEG’s members in the 2018 HCEG Top 10. These include the following:
Advanced Analytics (Ranked #1 on HCEG Top 10 List)
Clinical, operational and financial processes supported by ever-improving artificial intelligence, machine learning and natural language processing applications have been identified by many as a primary way to make everyone more proactive to improve outcomes and lower costs. And the importance of non-traditional data sources such as social determinants of health, consumer-generated data and data purchased from 3rd parties provide tangible cost savings, time savings and quality of care improvements.
Value-based Payment & Care (#3)
In spite of recent pullback by CMS on bundled payment initiatives and some delays in implementing certain regulations regarding value-based payment programs, information, products and services aimed at accommodating our aging population and increasing levels of chronic conditions are legion in the sessions, exhibit booths and hallway conversations at HIMSS.
Population Health Programs & Services (#2)
Results from the 8th Annual Industry Pulse report, based on the HCEG Top 10, make it is clear that the industry can’t get to value-based payment (VBP) without significantly enhanced clinical data, analytics and agreed upon measures. And VBP won’t succeed unless there is more focus on bringing communities together to change behaviors and how we think about approaching population health.
Sorting through all the overlapping platforms, data trends, and tools needed to complement the care team and provide patients with optimal outcomes at the lowest cost are no easy feat. Attendees exploring the exhibit hall in search of achieving efficient implementations, streamlined operations, scaled delivery across large markets have their work cut out for themselves this week.
Engaging Healthcare Consumers & Patients (#10)
Whether you agree or not, healthcare services and products are moving from a B2B to a B2C and B2B2C delivery model.
Recent announcements from non-traditional healthcare market participants like the Amazon-Berkshire Hathaway-JP Morgan Chase partnership and the CVS- Aetna merger make it clear that massive change in the traditional healthcare market – lead by the digitization of everything – is imminent. Duplicating the consumer engagement models these new healthcare market entrants have proven in other industries and markets makes it apparent that significant cultural and organizational changes are required to adapt to the digital transformation sweeping the healthcare industry.
Popular Hashtags At the 2018 HIMSS Conference
You can zero in on popular HIMSS-related themes using the following hashtags:
Check out this eBook from HIMSS on some of the innovation that will be on display at this year’s conference.
HCEG Sponsor Partners at HIMSS
If you’re at the HIMSS Conference, be sure to check out our sponsor partners exhibits, sessions and special events are hosting. Here are those we know about at this time. We’ll share more as they become known.
Visit Booth 5062 to get some water, soft pretzels, Tastykakes and learn more about Instamed’s offerings.
Keep your eyes peeled for more information, insight and ideas that HCEG members, sponsor partners and advisors will be gathering from Las Vegas this week. A special ‘HIMSS18-edition’ eNewsletter will be shared later this week including major takeaways, insights from conference thought leaders and some pictures capturing the event. If you aren’t already a subscriber to our newsletter, you can sign up here.
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 Diloreto
Senior VP of Healthcare-Population Health at General Electric
President & CEO at Blue Zones and former President & CEO of Healthways
HCEG Board Chair and COO/Consultant at Arches Health Plan
Senior 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.