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Healthcare Leaders Interviewed by Mabel Jong at HCEG’s 31st Annual Forum

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The 2019 Annual Forum of the HealthCare Executive Group (HCEG) took place on September 9th through the 11th at the Commonwealth Hotel in Boston, MA. In this 31st forum, healthcare leaders and other champions of healthcare system transformation had the opportunity to share their insight, ideas and information on key healthcare topics. Current investment trends, new business models needed to accommodate an increasingly consumer-focused marketplace, the imperative to decrease administrative costs, healthcare’s huge cost control problem, and other current challenges, issues, and opportunities of today’s uncertain healthcare environment were key themes.

Mabel Jong, principle at MJC Communications, LLC and professional on-camera interviewer, panel moderator and award-winning journalist with over two decades of experience specializing in healthcare and business news production interviewed a dozen healthcare leaders participating in HCEG’s Annual Forum. This blog post presents a number of these interviews.

For more information on HCEG’s 2019 Annual Forum including forum content, speaker presentations, and video interviews with forum speakers and attendees, visit this page.

Where Venture Capitalists are Focusing Their Healthcare Investments

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Ricardo Johnson, Senior Director – Healthworx, at CareFirst BCBS – shares insight on healthcare innovation and the types of investments corporate venture capital groups and private equity firms are making in health plans and risk-bearing payer/provider partnerships. Ricardo provides an overview of what he sees as key areas of focus for investment and where more investment is needed.

Differentiating Business Models to Serve High-Risk, Poly-Chronic Patients

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Ian Laird, National VP of Growth of DaVita Health Solutions, shares insight on value-based care, the unique needs of small patient populations that represent 40 to 50% of the total cost of care for a typical medical practice and the need for modern medical practices to accommodate differentiated business models.

Healthcare Innovation and the Importance of ‘Getting Out of Our Own Way’

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Dr. Jason Woo, MD, Founder of Learning Core Leadership Through Service, shares insight on the various mindsets that help or hinder healthcare executives as they transform their organizations. Dr. Woo notes that positive growth in healthcare has lagged that of most other industries and that healthcare still has the same problems now as it did 30 years ago.

RELATED: Healthcare Leaders Share Insight in Boston on September 9th

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Importance of Data & Analytics as Foundational Capabilities in Today’s Healthcare Organization

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Sara Stevens, VP of Healthcare Economics & Analytics Ops at Capital District Physicians’ Health Plan, shares her insight on the foundational nature of ‘Data & Analytics” – ranked #1 on the 2019 HCEG Top 10 list – in the highly regulated healthcare industry.

Taking Administrative Costs Out of the Healthcare Ecosystem

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David Querusio, CTO of Harvard Pilgrim Health Care shares insight on how recent hospital and provider group mergers may be taking administrative costs out of the system, the importance of developing and providing a ‘platform’, and strategic innovations taking place in the healthcare value chain on both the payer and provider side.

Healthcare’s Huge Cost Control Problem

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Niall Brennan of the Health Care Cost Institute (HCCI)  conveyed insight into HCCI’s cutting-edge research to help people understand why healthcare spending is the way it is, the geographic variation in how healthcare money gets spent nationally, and how the ongoing consolidation of healthcare markets can result in less competition and less flexibility for negotiations between providers, payers and employer groups.

Extracting Waste in Healthcare: An Imperative for Today’s Healthcare Leaders
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Bruce Jones, CIO of Excellus BCBS, shares his take on the need for healthcare leaders to look at every single process and figure out what the waste is in those processes and the need to take out that waste with new technologies like robotics process automation and artificial intelligence. Bruce also talks about the need for the healthcare industry to adopt more quality processes like Lean Six Sigma.

Remaining Focused in Disrupted Healthcare Environment

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Mariya Filipova, VP Innovation at Anthem, relates how to remain focused while dealing with all of the changes rapidly transforming healthcare. And how creative collaborations between formerly competitive organizations are coming together to improve outcomes and reduce costs. Mariaya also shares insight on the process of managing patient consent and provider credentialing as examples.

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Megan Callahan, VP Healthcare at Lyft, shares her take on Lyft’s experience providing non-emergency medical transportation to Medicaid and Medicare beneficiaries; how NEMT saves time and improves outcomes but also increases independence and happiness of those who utilize this increasingly common non-medical benefit.

Healthcare leaders. Healthcare Executive Group. HCEG Annual Forum. Venture Capitalists. High-Risk, Poly-Chronic Patients. Data & Analytics. Innovation. Transportation. Medicaid & Medicare Beneficiaries.RELATED: A Conference for Healthcare Executives Unlike Any Other

Impressions of HealthCare Executive Group’s 31st Annual Forum

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Sheri Johnson, AVP of Member Enrollment & Billing at UCare, an independent, non-profit health plan providing coverage and services across Minnesota and western Wisconsin on the importance of always striving to ensure the best member and patient experience, leveraging readily available member/patient data, and being open to creating or entering partnerships with others whose mission is complimentary toward improving healthcare outcomes and lower costs while sustaining longevity.

The HealthCare Executive Group and Its Evolution Over the Years

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Richard Lungen, Managing Member of Leverage Health and HCEG board member shares his take on what makes the HealthCare Executive Group and its long-running annual forum different than other healthcare conferences, how it’s participants have changed over the years to include not only health plans but health systems, various types of providers, investors and other diverse organization.

Healthcare Leaders Leverage the HealthCare Executive Group

In addition to our Annual Forum, the HealthCare Executive Group offers periodic Executive Leadership Roundtables, live presentations, webinars, regular blog posts, and other original and curated content to support the information and networking needs of today’s healthcare leaders. Our next events include the following:

Executive Leadership Roundtable at 2019 HLTH Forum

On Wednesday, October 30th, 2019 at 12:00PM to 3:00PM ET, the HealthCare Executive Group , in collaboration with the Center for Healthcare Innovation (CHI), International Association of Innovation Professionals (IAOIP), and Workgroup Electronic Data Interchange (WEDI) will present “Flying the Plane While Building the Plane: Do You Have What It Takes to Pilot the Transformation of Healthcare?

Learn more about and register for this free event – with lunch included – today!

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HCEG’s Executive Leadership Roundtable at 2018 HLTH Forum

Session at 2019 AHIP Consumer Experience & Digital Health Forum

HCEG will be presenting a session at the upcoming AHIP Consumer Experience & Digital Health Forum in Chicago on December 10-11, 2019, at the Swissotel. The session titled “Outlook 2020: Top 10 Challenges, Issues, and Opportunities as Identified by Healthcare Executives” will expound on the 2020 HCEG Top 10 and related information shared by participants of HCEG’s recent 2019 Annual Forum.

Subscribe to our eNewsletter for additional information on these events and other information of potential value to healthcare executives and thought leaders.

Part 2: Recapping ‘The 2018 HCEG Top 10 Healthcare Opportunities, Challenges & Issues’ Webinar

By | Cybersecurity, Executive Leadership Roundtable, HCEG Top 10, Pharmacy, Webinar Series | One Comment

The theme of last month’s HCEG Webinar Series event was The 2018 HCEG Top 10 – Healthcare Opportunities, Challenges & Issues. In a previous post, highlights of the following two topics that were discussed by moderator Kim Sinclair, HCEG board chair and CIO at Boston Medical Center Health Plan, and panelists Ferris Taylor, HCEG’s Executive Director and Consultant to Arches Health Plan and David Gallegos, Sr VP of Consulting Services at Change Healthcare, were reviewed:

  • Which three items on the 2018 HCEG Top Ten list three areas were of most interest?
  • What’s the state of healthcare consumerism and what’s being seen in the industry?

This second post recaps highlights from the second half of the webinar where the topics of Cybersecurity (Ranked #6 on the 2018 HCEG Top 10) and Addressing Pharmacy Costs (Ranked #9) were discussed. The webinar presentation materials and a recording of webinar can be found here.

Cybersecurity – 2018 HCEG Top Ten Item #6

Topic #3: How are you seeing cyber security and cyber threats impact healthcare organizations beyond the tactical day-to-day prevention activities?

HCEG Healthcare Executive Group Webinar-Top-10 Trends Cybersecurity

Ferris Taylor: “I think it’s (cybersecurity) fundamental that we need to innovate and improve cybersecurity in all of our healthcare processes. That really means giving people a confidence that their personal information won’t be used in ways that a person doesn’t want it to be used. So, it ties back to consumerism.

Real World Impact of Medical Identity Theft

“Here in Utah, about three years ago, there was a baby born in the hospital that was heroin addicted. And of course, the Department of Social Services immediately went to the home and removed the three other children from that home. The fundamental problem was that the mother of that heroin baby was not the mother in that home. And it took that mother three months to get her children back. It was a case of medical identity theft where the baby was born. The real mother checked out.  We can understand the personal impact that that lack of security around medical information caused for that family.”

David Gallegos: “The world has gotten a lot smaller and technology a lot more complex over the past decade. And clearly cyber terrorism is a big part and a growing concern that every organization needs to take seriously. But you need to keep in mind that the safest computer is one that’s turned off and unplugged. And clearly that’s not very useful.

“We need to balance both security and usability and the sharing of clinical information. It’s going to be critical to our care model redesigns and our clinical collaboration. This data is also going to be important for us to leverage artificial intelligence and, to help us determine optimal courses of treatment. In some cases, this information is even going to be needed to help really define how whole populations are treated.”

Addressing Pharmacy Costs – 2018 HCEG Top Ten Item #9

Kim Sinclair shared that pharmacy costs continue to rise and is a topic constantly in the news, noting that non-profit hospitals have stated intent of joining together to form their own pharmacy organizations.

Topic #4: What are your thoughts about what healthcare leaders can do about rising pharmacy costs?

Ferris Taylor: “I saw some statistics on pharmacy costs that struck me to the heart. It was from the Health Care Cost Institute over the last four years. It was actually 2012 to 2016 and the cost of prescriptions in the marketplace had gone up by 25%. But the utilization of prescriptions had only gone up by 1.8%. And it wasn’t just pharmacy costs. Emergency Room prices have gone up by 30% and visits went up by 2%.”

Free-Market Economy and Governance

“So, I think, once again, we haven’t transitioned from the buyer being the employer to the consumer becoming more and more important in that purchasing decision. As we discuss pharmacy costs, the other thing that I think we need to recognize is that we have a free-market economy. But industries have responsibilities to govern themselves. And I know some of the bad players in the pharmacy industry are outside of the Pharmacy Association. So, it’s hard to regulate them. But I use those key issues as the things to help us start to address the pharmacy costs”

David Gallegos on the State We’re in with Pharmacy Costs

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“What I look at the state we’re in with pharmacy costs. To me it’s entirely self-made. We’ve created these regulations that allow schemes like pay to delay, or evergreening – that’s really pushed generics out further in terms of their development. We create, in a sense, quasi monopolies.”

“We criminalize the ability to negotiate for larger population blocks. I mean it seems ridiculous to me, actually, that drugs that were invented and manufactured here in the United States can often be purchased cheaper outside of our country.”

“Clearly drugs are very important. They reduce admissions that would use other high cost care. And some of them are miracles. They can literally cure diseases – cure the incurable. So, I understand this is not a simple problem. But if a drug cost a million dollars and the person can’t afford it, is it really a miracle?”

“And in any other market, if there was a product that nobody could afford, the supplier would price it differently. And that’s what we have in our market.”

Previous Webinar: Strategies to Address Rising Pharmacy Costs

For more about pharmacy costs, see this recap of last December’s webinar titled “Strategies to Address Rising Pharmacy Costs” presented by our sponsor partner Cumberland Consulting Group.

Check out the Webinar Recording for More

For more insight on 2018 HCEG Top 10 and the perspective of healthcare executives, check the webinar recording and subscribe to our eNewsletter where we’ll be sharing more information, insight, opinions and ideas of value to healthcare executives and thought leaders. Our newsletter will also share information on future webinars and events like our Executive Leadership Roundtable in Las Vegas this coming May 9th.

A Unique Event and Exclusive Group for Healthcare Executives

By | Annual Forum, Executive Leadership Forum, Member Benefits, Sponsor, The Industry Pulse, 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.