HCEG Webinar Series. Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization. The Golden Triangle. Operational efficiency. 2019 HCEG Top 10 list. HealthEdge. business transformation initiatives. Sal Gentile, Friday Health Plans.

The Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization

By | HCEG Top 10, HealthEdge, Operational Efficiency, Webinar Series | No Comments

People, process, and technology are at the core of every business. And how these three critical components are used to create and deliver a healthcare organization’s products and services ultimately result in company profitability and growth. Indeed, the critical challenges healthcare organizations are facing during these uncertain times involve humans, the processes they must follow, and the mix of entrenched, emerging – and as yet- often unknown technologies supporting an organization’s mission and growth.

Transforming your healthcare organization requires an explicit focus on effectively aligning the Golden Triangle of People, Process, & Technology.

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The Golden Triangle: People, Process, & Technology

HCEG Webinar Series. Art & Science of Aligning People, Process, & Technology to Grow Your Healthcare Organization. The Golden Triangle. Operational efficiency. 2019 HCEG Top 10 list. HealthEdge. business transformation initiatives. Sal Gentile, Friday Health Plans.

Delivering operational efficiency, a key aspect of transforming today’s healthcare organizations requires an approach that optimizes the relationships between people, process & technology; hence the Golden Triangle. Each part of the Golden Triangle is its own science. And each needs to be mastered to effect true transformation and business growth. Ignore the relationship between people, process, and technology at your own risk.

And know that the art, where real value and efficiency are found, is at the intersection of people, process & technology. Like a three-legged stool, each part of the Golden Triangle must be sufficiently developed and aligned as integral components of successful transformation initiatives. Too often, healthcare organizations give short shrift to the people point of the triangle.

RELATED: Operational Efficiency Ranked #7 on 2019 HCEG Top 10 List

Successful Transformation Initiatives: Keys to Success & Challenges

In a study by IBM titled “Making change work…while the work keeps changing,” 1400 participants identified the keys to successful change initiatives and the major challenges to change that organizations must consider as they plan and strategize their business transformation initiatives.

Keys to Successful Change Initiatives at Healthcare Organizations

People Factors

    • Employee Involvement
    • Honest and Timely Communication
    • Change Agents to Engage Other Employees
    • Change Supported by Culture
    • Efficient Training Programs
    • Monetary and Non-Monetary Incentives

Process Factors

    • Adjustment of Performance Measures
    • An Efficient Organizational Structure
    • Top Management Sponsorship

Challenges to Change Initiatives at Healthcare Organizations

People Factors

    • Changing Mindsets and Attitudes
    • Corporate Culture
    • Shortage of Resources
    • Lack of Commitment by higher management
    • Insufficient Change Know-How
    • Little to no Transparency

Technology Factors

    • Impact on Existing Process
    • User Experience
    • Flexibility and Interoperability of Technology Systems

See this article for more about the keys to successful change initiatives and the major challenges to change that organizations must consider as they transform their organization.

People are Key to Aligning People, Process, & Technology

Famed IBM founder Thomas J Watson shared the following on the importance of NOT ignoring the people component of organizational change initiatives.

“Teach your associates to teach themselves and in a way that you will strengthen the entire organization” – Thomas J Watson (1947)

Insight & Ideas on Leveraging People, Process, & Technology

In today’s uncertain and rapidly changing healthcare environment, healthcare leaders are seeking to enter new geographies, start new lines of business, or even radically transform their traditional way of doing business. To position your healthcare organization for successful growth by optimizing the intersection of people, process, and technology, check out the recording of this webinar – Using People, Process & Technology to Grow Your Business – presented by our sponsor HealthEdge on July 25th of 2019.

Sal Gentile, CEO of Friday Health Plans and our sponsor partner HealthEdge shared how they leveraged the art and science of people, process, and technology to successfully grow their respective healthcare organizations both from the ground up as well as within an established organization.If you have any questions about this blog post or want to learn more about the HealthCare Executive Group, please reach out to us at [email protected]. Also, consider following @HCExecGroup on Twitter and LinkedIn.

Recapping Value-Based Payment – Getting from Here to There…

By | HCEG Top 10, HealthEdge, Next Generation Payment Models, Value-Based Payment/Care, Webinar Series | No Comments

Our sponsor partner HealthEdge hosted HCEG’s Webinar Series event in March: Value-Based Payments – Getting from here to there…

Harry Merkin, VP of Marketing at HealthEdge and Dave Mika VP of Enterprise Core System Operations at Independent Health shared insight and real world experience on how health plans and their provider networks can transition from traditional fee for service (FFS) to value-based payment (VBP).

This blog post recaps highlights of the webinar and provides access to additional information from the webinar. A recording of the webinar can be found here. You can also check out this Twitter Moment summarizing live Tweets from the webinar.

Value-Based Payment Began in the Late 1990’s 

In the late 1990’s, capitation models began paving the way for change from traditional FFS payment models to models focused on helping establish effective, cost-efficient practice models. In the last few years, value-based payments have become the latest and greatest models for reimbursement of care. The importance of value-based payments is supported by HealthCare Executive Group members ranking Value-Based Payment as #3 on the 2018 HCEG Top 10 list.

Moreover, recent statements by current and former HHS officials have supported the need for value-based payment:

“There is no turning back to an unsustainable system that pays for procedures rather than value”, and the transition “needs to accelerate dramatically.” – Alex Azar, Secretary of HHS, 3/5/18 at the Federation of American Hospitals’ conference

“I highly encourage health care leaders to listen intently to his full remarks. The transition to value is moving forward; if you aren’t already preparing for it, it is time to get on-board.“ – Michael Levitt, former governor of Utah and former HHS Secretary

Value-Based Payment Can Lower Costs and Improve Outcomes

Harry Merkin shared the results of a November 2017 Humana study showing that VBP programs achieve meaningful gains in cost and quality vs. traditional FFS methods with total healthcare costs associated with VBC plans 15% lower than care costs of FFS plans. And a more recent survey by the Healthcare Financial Management Association revealed that 70% of healthcare organizations participating in VBP programs have achieved positive results.

Value-based Payment Must Address the Quadruple Aim

Independent Health’s Dave Mika shared real-world insight into the experience his organization has witnessed. A key focus raised by Dave is that health plans looking to implement or extend value-based payment programs must address the four pillars of the Quadruple Aim

  1. Enhancing patient experience
  2. Improving population health
  3. Reducing costs
  4. Improving the work life of health care providers

Questions from Webinar Participants About Value-Based Payment

HCEG webinar series events always include the opportunity for questions from participants and this webinar was no exception. Two of many questions included the following short, paraphrased responses by Dave Mika – and other questions can be obtained from the webinar recording:

What is the key to gaining alignment with PCP’s?

Answer: Actively reaching out to and collaborating with key stakeholders in the local community.

What data has proven to be most useful to the provider network?

Answer: Information on patient gaps in care– ideally provided at the point of care in the physician’s workflow – can be very effective in improving value.

And More on How to Get There from Here…

In addition to the above, the webinar addressed the following considerations for transitioning from traditional FFS programs to VBP programs:

  • Aligning delivery and reimbursement models with high-performing providers
  • Tools for members to self-manage and self-navigate the care delivery system
  • Technology support including web and digital capabilities

The move to value-based reimbursement appears inevitable, and only those health plans and providers that begin to transition and adapt today will be successful in the future. Change doesn’t happen overnight. To learn more about how making the transition from FFS to VBP, check out the webinar recording, consider contacting HealthEdge for more information and keep in touch with the HealthCare Executive Group by connecting with us on Twitter, Facebook, LinkedIn and subscribing to our newsletter.

Recap of Webinar: ‘Care Redesign: Lowering Costs While Improving Patient Outcomes’

By | HealthEdge, Sponsor, Value-Based Payment/Care, Webinar Series | No Comments

As more Accountable Care Organizations (ACO) are formed and as value-based reimbursement arrangements between payers and providers expand, the need for assessing non-traditional drivers of health outcomes, leveraging payer, provider and community resources and enhancing collaboration between patients, providers and payers are becoming key to improving outcomes and managing costs.

Our Thursday, October 26, 2017, Harry Merkin, VP of Marketing at our sponsor partner HealthEdge teamed up with Barbara Berger, VP of Care Management at First Care Health Plans, to present “Care Redesign: Lowering Costs While Improving Patient Outcomes,” HealthEdge’s entry in this month’s HCEG Webinar Series.  The webinar presented innovative, real-world examples of how First Care Health Plans is improving member outcomes and lowering their cost of care via three primary approaches:

  1. Collaborating with providers and health systems
  2. Partnering with community resources
  3. Making critical information available to key stakeholders

Addressing Discontinuances of Care

Barbara shared that, while the high volume, time-sensitive nature of healthcare delivery often leads to a discontinuance of care delivery and management between the silos in which payers and providers often operate, the increased data sharing associated with the emergence of ACO’s and value-based reimbursement and care models are helping to align care provided by providers and health plan payers. Examples of balancing the proper people, processes and technologies were shared.

Population Assessments and Social Determinants of Health

Barbara emphasized the importance of carefully and thoroughly assessing an individual’s health care, behavioral and social needs as part of a periodic, recurring population assessment and how doing so can have a key, beneficial impact to healthcare outcomes.  And with “Social Determinants of Health” forming the basis (bottom) of Maslow’s Triangle of Needs, First Care is starting to include an assessment of member’s social determinants of health in their population assessment program. Factors such as the following are included in the population assessment:

  1. Access to Healthcare Services
  2. Access to Food
  3. Access to Local Community Resources
  4. Access to Transportation Options
  5. Public Safety
  6. Financial Status

After Barbara shared her insight on this currently popular topic, Harry Merkin stated: “The phrase ‘social determinants of health’ is no longer a buzzword!”

Addressing Social Determinants of Health

Barbara shared an overview about First Care’s “Expecting the Best Maternity Program” that combines case management and utilization management to complement care provided by physicians while guiding and supporting members – and their family – through member pregnancies; particularly high-risk pregnancies.

Besides services such as assistance with locating medical providers, toll-free 24/7 access to a clinician and a package of select products and services aimed at supporting pregnant women, the program also includes an innovative “Nurse-Family Partnership” where a First Care nurse is paired with an expecting family to help the patient and her immediate family members understand and manage the pregnancy. First Care nurses regularly reach out to ask questions on how the pregnancy is progressing and answer any questions the patient and family may have.

The program has resulted in a significant per decrease in NICU maternity admissions.

The Recording, The Content and More Insight from HealthEdge

The webinar presented three considerations for payer-provider population health programs:

  1. Be methodical about population assessment
  2. Integrate People, Process and Technology with Providers
  3. Use value-based contracts to align vision of member/patient care

You can learn more about how collaborating with providers and health systems, partnering with community resources and making critical information available to key stakeholders can improve outcomes and lower costs by checking out this recording of the webinar and these few slides from the presentation. If you would like more information or if you have any questions on the content of this webinar, please feel free to contact HealthEdge too.

More Information

HealthEdge Website

HealthEdge on Twitter

First Care Website

First Care on Twitter

If you’re not a HCEG member and would like more information on becoming a member, please see this page or email Juliana Ruiz.