2019 Industry Pulse Survey value-based payment Value-Based Relationships & Reimbursement:

Value-Based Relationships & Reimbursement: How can Industry Collaborate to Speed the Move to Value?

By | Events, HCEG Top 10 | No Comments

Value-based Payment (and Value-based Care Reform) has ranked among HCEG’s Top 10 list of challenges, issues, and opportunities each of the last 10 years that HCEG’s Top 10 list has been published; a clear indication healthcare leaders realize that the move to payment for outcomes (value) vs. volume (FFS) is inevitable. It’s clear that value-based relationships & reimbursement is important to health plans, health systems and provider organizations. But year after year, shared-risk, value-based healthcare appears to be just around the corner. Why so slow? How can healthcare leaders championing the transformation of America’s healthcare system finally begin to realize the value of value-based payment?

In fact, the majority of respondents to the 2019 Industry Pulse Research Survey indicate that value-based relationships including both upside and downside shared risk still appears to be three to five years off.2019 Industry Pulse Survey value-based payment

If what’s apparently widely thought, then why is the move by health plans, health systems, and healthcare providers to value-based reimbursement perpetually stuck at being three to five years away from adopting shared-risk value-based contracts?

Join Us at Hotel Commonwealth for our Complimentary Executive Leadership Roundtable – Breakfast is Included

Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,Speeding the Move to Value-Based Relationships & Reimbursement

On Wednesday, September 11th, the HealthCare Executive Group is presenting a special Executive Leadership Roundtable as part of their 31st Annual Forum. This interactive roundtable event open to everyone who’s in Boston on September 11th – there’s no charge to join other healthcare leaders from across the country to learn about value-based care and meet others facing similar challenges. To be clear, this special ELR event is open to everyone.

Participants of this special ELR will benefit from:

  • Interactive discussion between attendees and speakers on what the movement to value means
  • Learning about the top challenges and opportunities in transitioning from payment for volume
  • Why healthcare organizations are hesitant to provide value-based care and thoughts on overcoming them
  • Understanding realistic next steps healthcare leaders can take to make real progress in the move to value
  • Recent successes in new payment models and lessons-learned
  • A look at cross-industry partnerships in the movement to value-based care reimbursement

This will be a rare opportunity for Healthcare Champions who gather in Boston on September 11th to learn more about value-based payment and care opportunities and to interact with speakers and other participants on a meaningful basis.

The $64,000 Question (Or the $64B+ Question?) – Always 3 to 5 Years Away

Why is the move by health plans, health systems, and healthcare providers to value-based reimbursement perpetually stuck at being three to five years away from adopting shared-risk value-based contracts?

To learn how to advance value-based care, join us at the Hotel Commonwealth for our September Executive Leadership Roundtable event -Value-Based Relationships & Reimbursement: How can Industry Collaborate to Speed the Move to Value? -and learn from the following session leaders and ELR participants:

Panelists Sharing Insight on Value-Based Relationships & Reimbursement

Moderator: David Di Loreto, MD – Principle – Sg2

Panelists:

Join Others to Learn About Value-based Care in Boston on September 11, 2019

Be a part of this unique, no-cost learning and networking opportunity on the last day of the HealthCare Executive Group’s 31st Annual Forum. Breakfast is included and registration is required.

Healthcare Innovation and Disruption, HealthCare Executive Group, HCEG, 16th Annual World Health Care Congress (WHCC), CIO & CTO Strategy Track, innovation, disruption. healthcare champions, Data Analytics, Pharmacy Costs and Transparency, Importance of Useable Technology, Cybersecurity, HCEG Top 10, Center for Healthcare Innovation (CHI), International Association of Innovation Professionals,

Rising Pharmacy Costs – Strategies to Address – Webinar Recap

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

It’s no secret that rising pharmacy costs are a serious challenge for the health plans, health systems, sponsors and individuals on the hook for paying for them. Our healthcare executive members ranked “Addressing Pharmacy Costs” as #9 on the 2018 HCEG Top 10 list.

How Can Health Plans and Health Systems Address Rising Pharmacy Costs?

On Wednesday, November 13, 2017, Pete Biagioni, Managing Partner at Cumberland Consulting Group, and Marcia Lambert, Partner at Cumberland Consulting Group presented “Strategies to Address Rising Pharmacy Costs,” Cumberland Consulting Group’s entry in this month’s HCEG Webinar Series. 

The webinar provided attendees with a lot of great insight and information on the following:

  1. An overview of trends in growth of pharmacy costs
  2. Pharmaceutical Distribution Channels
  3. Drivers of specialty pharmacy spend
  4. Drug cost management strategies
  5. What strategies health plans and health systems can implement to address rising pharmacy costs

Trends in Rising Pharmacy Costs

Rising pharmacy costs trends Specialty Pharmaceuticals Management Strategies Distribution Reimbursement System Provider Administered, Outpatient Prescription Drugs

Specialty Pharmaceuticals – a 95% increase in just two years!

Pete Biagioni kicked off the presentation by highlighting that prescription drug spending is now the largest category in healthcare benefit spending – outpacing specialty care, inpatient and outpatient costs. Pete added that not only is prescription drug spending the largest healthcare expense but it’s also the fastest-growing category of benefit spending!

Largest contributor to increases in rising pharmacy costs are Specialty Drugs – with a 95% increase* in just two years!

How Drug Prices are Determined in the United States

One interesting part of the presentation was Marcia Lambert’s overview of the Pharmacy Distribution and Reimbursement System for Patient-Administered vs. Provider Administered, Outpatient Prescription Drugs in the U.S.  Several very detailed and informative slides were shared.  These slides identified the product flow, contractual arrangements and financial payments between the myriad of entities involved with pharmacy distribution in the U.S.

Specialty Pharmacy Trends & Drivers of Specialty Pharmacy Spend

A good part of the presentation covered specialty pharmaceuticals, which are growing at a CAGR of 17% as more products are being developed to treat orphan diseases and provide newer therapies. Some specialty pharmacy trends include:

  • As more specialty drugs are dispensed, a shift away from the buy-and-bill system (reimbursement through medical benefit) to the pharmacy (reimbursement through prescription drug benefit) can be expected.
  • As SPs gain more revenue and market share, they’ll come under more scrutiny and attempts at cost containments from payers.
  • The healthcare system’s grudging acceptance of high-priced orphan disease drugs has given manufacturers more incentive to develop low-volume SP drugs.
  • The high cost of SP’s will demand more Value-Based/Outcomes-Based evidence

Pharmacy Cost Management StrategiesRising pharmacy costs trends specialty pharmacy Management Strategies Distribution Reimbursement System Provider Administered, Outpatient Prescription Drugs

The Cumberland presenters provided an overview of traditional Strategies to Manage Rising Pharmacy Costs and then dived into a LOT of detailed information on the pros and cons of newer, novel strategies for managing pharmacy costs including:

  • Comprehensive Medication Review / Medication Therapy Management
  • Specialty Pharmacy Coordination & Management
  • Outcomes-based Contracting
  • ‘DIR’ Fees – Direct and Indirect Reimbursement

The Future – Pharmacy Trends and Government Intervention

This rapid paced presentation moved toward its conclusion with Pete Biagioni sharing a few slides listing some ways that government intervention might impact prescription drug prices. And the webinar completed with a short listing of future trends for prescription drugs in the U.S. The entry of Amazon and mega deals like CVS buying Aetna being two likely major impacts.

The Recording, The Content and More Insight from Cumberland Consulting Group

The above is just a portion of the information presented by our sponsor partner Cumberland Consulting Group. You can learn more about “Strategies to Address Rising Pharmacy Costs” by reviewing the entire recording of the webinar available here.  If you’d like more information or if you have any questions on the content of this webinar, please feel free to contact Cumberland Consulting Group. You may also want to follow Cumberland on Twitter.

*Per CMS 2014  fact sheet: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html

 

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

By | Events, Partners | No Comments

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

Leverage Your AHIP Event & Nashville Connection

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

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

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

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

Timely Topics for Healthcare Leaders

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

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

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

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

Reserve Your Seat Today!

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

Healthcare Executive Leadership Forum at Guidewell Innovation Center

HCEG Attends the 2017 Healthcare Summit & CMA Celebration in Nashville

By | Events, Partners | No Comments

Source: emids

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

More About the 2017 Healthcare Summit & CMA Celebration

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

Dominant Themes at the Summit

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

Impact and Continued Entrance of “Outsiders”

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

Importance of Data Liquidity and Exchange

Click for more info

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

Engaging Healthcare Consumers & Patients

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

Trust Among All Healthcare Constituents

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

Source: emids

Come Back for More – And Going Back to Nashville

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

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

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

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

NHITWeek National Health IT Week HealthIT healthtech HIMSS HCEGToday marks the start of National Health IT Week (#NHITWeek,) a collaborative and partner-driven event whose purpose is to promote the awareness and demonstrate the use of information technology in:

  • Supporting Healthcare Transformation: The many ways in which health IT is driving transformation in healthcare delivery including improvements in quality and safety, interoperability, advances in innovation, and patient and consumer activation and engagement.
  • Expanding Access to High Quality Healthcare: Use of innovative technologies including telehealth and remote patient monitoring to improve healthcare access, coordination and outcomes.
  • Increasing Economic Opportunity: Highlighting the importance of a robust, diverse health IT workforce and health IT’s role in supporting economic growth.
  • Making Communities Healthier: The fundamental role health IT plays in supporting population and public health

As a group of executives, thought leaders and advisory partners serving health plans, health systems and provider organizations throughout the United States, the Healthcare Executive Group (HCEG) is proud to partner with and to support National Health IT Week and the above points of engagement – this week of October 2 – 6, 2017 and throughout the year. You can learn more about #NHITWeek and related events here.

The 2018 HCEG Top 10

To kick of National Health IT Week, the Healthcare Executive Group is pleased to announce the formal release of the 2018 HCEG Top 10 list of opportunities, challenges and issues facing executives of health plans, health systems and provider organizations in the United States.

The HCEG Top 10 has been a keystone of the Healthcare Executive Group for over 13 years and provides insight into the most current, pressing priorities facing their industry. Based on HCEG member input and sponsor partner research, the HCEG Top 10 serves as a framework for continuous and evolving dialog among healthcare executive members on the critical opportunities, challenges and issues facing their organizations. Educational programming including periodic Executive Leadership Round Tables, research initiatives, monthly webinars, whitepapers, blog posts and ongoing member discussion are all driven by the HCEG Top 10.

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

Help Spread the Word About National Health IT Week

Never before has the digital transformation of healthcare been so pervasive and rapid. Health information technology is key to advancing the imperative points of engagement emphasized during National Health IT Week. Please join the conversation on social media by using the #NHITWeek hash tag. Share how you and/or your organization is using health information technology to transform points of healthcare and health outcomes.

HCEG will be participating in NHIT Week by sharing content via its social channels, member LinkedIn pages, and via this blog. For more information, insight, ideas and commentary about National Health IT Week, healthcare, healthcare information technology and the digital transformation of healthcare, consider following us on Twitter, LinkedIn and Facebook – and subscribe to our eNewsletter.

A Unique Event and Exclusive Group for Healthcare Executives

By | Events, HCEG Top 10 | No Comments

Our 2017 Annual Forum came to a close at noon this past Wednesday. Over 110 healthcare executives, nationally known healthcare speakers and industry thought leaders gathered in Nashville, TN – Music City and the Healthcare Capital of the United States – to share their insight, ideas and concerns about healthcare reform and digital transformation during these rapidly evolving, uncertain times in healthcare.

The 29th Annual Forum featured three keynote speakers, nine sessions covering the latest topics of interest to executives leading health plans and health systems and three nighttime events structured to support networking between forum participants. All in all, the two and half days of our 2017 Annual Forum added up to one incredible opportunity for those leading the digital transformation of healthcare reform in the United States to come together on an intimate basis , to share and learn with each other collaboratively.

The 2018 HCEG Top 10 List

As has taken place during each of the last seven HCEG Annual Forum events, participants selected and voted on the Top 10 Opportunities, Challenges and Issues facing health plan and health system executives over the coming months and year. This new 2018 HCEG Top 10 list will drive the focus of Executive Leadership Round Tables, webinars, content development and other collaborative opportunities throughout the remainder of 2017 and the coming new year.

What We’ll Be Sharing From Our 2017 Annual Forum

Over the next few weeks, insight, ideas, opinions and concerns generated during the forum will be shared with members and the public at large. We’ll recap forum speaker and participant insight and opinion into how healthcare in the United States will be impacted by healthcare policy reform, digital transformation initiatives and both national and state-level actions. Readers of this blog, our friends on social media, attendees of our webinars and round tables and subscribers to our newsletter can look forward to how speakers, panelists and participants at our 2017 Annual Forum shared insight on the following:

  • How Clinical and Data Analytics leverage clinical evidence to segment populations, manage health and drive decisions
  • How the emergence of Population Health Services Organizations are operationalizing population health strategy, chronic care management, driving clinical integration, and integrating social determinants of health
  • How Value-Based Payments are being used to target specific medical conditions to manage cost and quality of care
  • How Cost Transparency is inevitable due to growing legislation and consumer demand
  • And more certain topics that can help healthcare leaders address transformation during these uncertain healthcare times

How We’ll Share

The Healthcare Executive Group will share the following via its web site, blog, social channels – including Twitter, LinkedIn an Facebook, and via other channels including member LinkedIn accounts, sponsor partner media and healthcare industry media. Look for the following:

  • Quotes from Keynote Speakers & Panelists
  • Session recaps including Presentation Materials
  • Thoughts from Forum Participants including social media shares
  • Audio Soundbites
  • Pictures and more

How to Stay Connected

To have this valuable information pushed to you, subscribe to our newsletter, follow the Healthcare Executive Group on LinkedIn, Twitter and Facebook; and consider becoming a member of our unique organization of Healthcare Executives. Learn more about the Healthcare Executive Group here.

Healthcare Executive Group’s 2017 Annual Forum – Just Right!

By | Events, HCEG Top 10 | No Comments

The Annual Forum hosted by the Healthcare Executive Group (HCEG) is the Goldilocks of Healthcare Gatherings. It’s not too big like the HIMSS Conference and the AHIP Institute. It’s not too small and too narrowly focused like so many of the single topic, function-specific events taking place all over the United States on any given week of the year. HCEG’s Annual Forum is a well-crafted gathering covering an agenda presented by credible industry leaders to a manageable group of attendees in an intimate and comfortable setting. HCEG’s Annual Forum is Just Right.

The 2017 HCEG Annual Forum – It’s Just Right!

This year’s Annual Forum takes place in what’s arguably the Healthcare Capital of the United States: Nashville, TN! Healthcare executives and thought leaders representing health plans, health systems, provider organizations and physicians – along with a select set of healthcare vendors – will gather at the Thompson Hotel Nashville on September 18th through the 20th to participate in this Just Right event.

Here’s a sneak peek at the topics, speakers and valuable activities planned for the 2017 Annual Forum in Nashville. (*Sessions and Presenters Subject to Change)

Certain Topics in an Uncertain Healthcare Environment

Based on the HCEG Top 10 and recent survey’s completed by healthcare executives and others, HCEG board members have identified the following topics that will be addressed in various sessions during the forum:

  1. Value-Based Relationships leading to Payer/Provider Integration
  2. Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives
  3. Specialty Networks and Risk Sharing at Scale
  4. Pharmacy Costs / PBM and Rx Transparency
  5. Precision Medicine and Behavioral Health Aspects of Substance Abuse/Opioids
  6. Leading Edge Technology / Disease Management / Population Health
  7. Technology Innovation and M&A Market Trends
  8. Total Consumer Health
  9. Harnessing Digital Health Technologies

Keynote Speakers

A number of well known AND well qualified individuals will be presenting at the Annual Forum and participating in various panels. While speaker arrangements are still be finalized, attendees can expect the following roles and industry focus to be represented:

  1. CEO of well known, nationwide health and wellness company
  2. Chief Marketing Officer of a Fortune 50 technology company
  3. Former executive director of national healthcare association
  4. Former leading official from the Centers for Medicare & Medicaid Services
  5. CEO of large multi-state healthplan
  6. Chief Medical Officer of large BCBS licensee
  7. President of national health care intelligence and policy consultancy

Evening Receptions

Besides the wonderful breakfasts and lunches catered each day of the forum, and the plentiful snacks and drinks available each day of the forum, a few other special events – all fueled with great food, drink and conversation – are part of the Annual Forum.

  • Sunday Evening: Meet and Greet at The Thompson Hotel
  • Monday Evening: Offsite Sponsor/Partner Reception
  • Tuesday Evening: “Late Night Nashville” Party

Come Join Us in Nashville This September!

For more information on the 2017 Annual Forum including membership in the healthcare executive group and registering for the Annual Forum, see this page. We hope you’ll join us.

Healthcare Executive Leadership Forum at Guidewell Innovation Center

Operationalizing Before Analyzing: Healthcare’s Modern Journey Powered by Data

By | Events, Sponsor | No Comments

Operationalizing analyzing data in healthcare organizations innovation programsOperationalizing data and analyzing data are not the same thing. Some healthcare organizations have made the painful and expensive mistake of focusing their innovation programs and growth investments on the “shiny ball” of analytics – the end stage of the data journey – instead of first improving the agility, speed and quality of the initial “operational” stages of the data journey: combining, enriching, indexing, searching, harmonizing, and alerting data. When it comes to operationalizing data and using information to help run the business, healthcare organizations must not fail to address numerous data silos, point-to-point integrations and other significant data-related challenges exacerbated by the lack of enterprise features such as security, transactional support, performance, and governance.

An Executive Leadership Forum Event

On Monday, 5/8/17 at 3:00 to 5:30 pm EDT, healthcare business and technology executives will meet at the GuideWell Innovation Center (Orlando, FL) to hear from healthcare business and technology leaders who’ve used “Next Gen” data concepts, strategy and technology platforms to fuel their industry innovation programs and digital transformation. This special healthcare executive leadership forum event is hosted by the Healthcare Executive Group (HCEG) and supported by HCEG’s sponsor MarkLogic and Intel. The event is open to all HCEG members and healthcare leaders, is free of charge and will be followed by a networking happy hour reception. Attendees of the 2017 Blue Cross Blue Shield National Summit may find this forum to be a great way to leverage their attendance at the Blues Summit.Healthcare Executive Leadership Forum at Guidewell Innovation Center

Who Should Attend?

Any healthcare executive with mission critical projects that require improved data agility and faster time to delivery should consider attending this unique leadership event:

  • Business Executives (operations, administrative, clinical) responsible for business “digital” modernization & improving experience / satisfaction initiatives.
  • Technology Executives (integration, architecture, infrastructure, development, security) charged with implementing and supporting operational and analytical data integration platforms to achieve business goals.healthcare executive leadership forum event - national blues summit orlando florida

What Business Executives Will Take Away

  • More insight into the competitive advantage and cost-savings a 360-degree view of Anything – member/patient, provider, etc. – can bring to a healthcare organization.
  • How creating profiles / preferences enhance engagement and experience while improving Net Promoter Scores (NPS).
  • Understanding of the business advantages and opportunities associated with ‘Next Gen’ data architecture and technology.
  • An understanding of use cases that increase business agility and improve time to market.
  • How continuous security, governance and sharing of data that’s usable and actionable is key to enabling growth and innovation.

What Technology Executives Will Take Away

  • An understanding of modern, multi-model “platform” approaches for integrating disparate data silos into a single operational and analytical infrastructure (secure, ACID compliant, etc.).
  • Awareness of the landscape of data technology vendors offering data platform solutions.
  • Why standalone, point solution “apps” or data “tools” present significant vendor lock-in risk.
  • How a metadata search approach supports rapid enterprise integration of structured and unstructured data.
  • Better understanding why top national healthcare organizations are implementing “Next Gen” data hub Centers of Excellence (CoE) to power their innovation programs and digital transformation.

More on Healthcare’s Modern Journey

For more information on leading the modernization and transformation of healthcare in 2017 and beyond, consider joining the Healthcare Executive Group and following us on our digital channels: Facebook, LinkedIn and Twitter. You can also subscribe to our bi-weekly newsletter.

The Future of the State Exchanges: Post Election

By | Events, Partners | No Comments

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

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

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

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

  1. State-based Exchanges are better positioned than others

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

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

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

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

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

Look closely…that’s a turtle under there!

  1. Trigger Points & Timeline – and Things to Watch

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

Additional Info on Potential Impact to ACA and Health Insurance Exchanges

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

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

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

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

Check out the following for more information on:

Ferris W. Taylor

Healthcare Executive Group

Benefits of being an HCEG member