As America celebrates Thanksgiving, the HealthCare Executive Group (HCEG) is honored to thank our sponsor partners and acknowledge the support these leading healthcare companies have provided and continue to provide to our healthcare executive members, industry advisors, and associates throughout the year. Through the support of the companies highlighted below, HCEG is able to provide a comprehensive package of information, insight, and networking opportunities.
HealthCare Executive Group – Gold Sponsors
Appian delivers the speed of enterprise low-code and the power of industry-leading intelligent automation. It’s the secret weapon to put your Digital Transformation on the fast track.
Improve decision-making with real-time access to patient, member, and provider data. Appian helps healthcare payers and providers speed innovation, help consumers take control of their own health, and simplify the healthcare journey.
CareCentrix has developed purpose-built technology, analytics, and experience to guide care that keeps patients on the path to the ultimate site of care: home. To address the complexities of post-acute care, CareCentrix engages patients and caregivers, coordinate care transitions, improve clinical outcomes, and do all we can to help patients heal or age at home.
By finding new ways to break down the silos across the continuum of care, CareCentrix is able to identify and capture savings health plans can count on.
Solera connects patients, payers, and physicians to a network of partners who are preventing and managing chronic disease.
Working with Solera, health plans and other payers securely and efficiently leverage a network of community-based and digital health solutions.
Solera helps employers identify and engage those in their workforce with the greatest opportunity for obesity-related chronic disease prevention.
Change Healthcare consulting is a catalyst for your value-based healthcare system. Change Healthcare is a healthcare technology company that offers software, analytics, network solutions, and technology-enabled services to help create a stronger, more collaborative healthcare system. Change Healthcare helps deliver measurable value not only at the point of care, but also before, after, and in between care episodes.
Cumberland Consulting Group is a leading healthcare consulting firm providing strategic advisory, implementation, optimization and outsourcing services to some of the nation’s largest payer, provider, and life sciences organizations.
Health insurers must act quickly to launch new offerings targeted at member populations in specific market segments. Whether a government program, commercial or individual product, or dental or TPA offering, HealthEdge works with transformative health plans to create and maintain a competitive advantage.
HighPoint implements effective IT solutions for payers and providers. HighPoint Solutions tunes out the noise so you can focus on improving healthcare delivery.
InstaMed powers a better healthcare payments experience on one platform that connects consumers, providers, and payers for every healthcare payment transaction. InstaMed’s patented, private cloud-based technology securely transforms healthcare payments by driving electronic transactions, moving money and healthcare data seamlessly and improving consumer satisfaction.
RedCard helps health plans and TPAs use the power of secure data to build stronger, more effective communication with your members and providers.
Softheon delivers cloud-based solutions that create a retail-like, user-friendly experience and provide personalized communication and real-time support to boost member engagement. Cost effective, and configurable software that supports health plans and states with enrollment, member billing, and reporting for over 3.2M Americans.
Unlike what many organizations allow, our sponsor partners must check their sales and marketing interests at the door. HCEG sponsors participate as supportive thought leaders to HCEG members and associates. HCEG events and content exclude advertising and marketing-speak and participants at our events will never encounter vendor exhibits. Those reading our content and attending our webinars will not be bothered by sales pitches, pop-ups and banner ads.
For more information on the benefits of becoming an HCEG Sponsor in 2019, check out our Sponsorship Prospectus.
Join Digital Healthcare Leaders & AHIP Forum Attendees in Nashville
In addition to lunch and networking opportunities, participants will enjoy the unique perspective and long-running insight of two distinguished panelists: Brian Lobley, President, Commercial and Consumer Markets at Independence Blue Cross and Stuart Hanson, Managing Director, Head of Healthcare Payments at JPMorgan Chase & Co. HCEG’s Executive Director Ferris Taylor will moderate the roundtable.
2018 celebrates the 30th anniversary of the Healthcare Executive Group – an organization dedicated to supporting and convening senior level executives focused on continuous innovation, evolution, and transformation of the healthcare industry. As part of our mission of promoting healthcare innovation, providing innovative knowledge support and helping to foster and sustain the development of life-long business relationships through real-life and virtual relationships, each year our members develop the HCEG Top 10 list of opportunities, issues, and challenges. This year marks the 10th anniversary of the HCEG Top 10 list of Challenges, Issues & Opportunities.
Healthcare Executives Identify Top Challenges, Issues & Opportunities for 2019
During our 2018 Annual Forum in Minneapolis last week, HCEG executive members from the payer, provider, and technology partner organizations voted on and ranked the Top 10 critical challenges, issues and opportunities they expect their organizations to face in the coming months and throughout 2019.
Starting with a list of 25 topical areas selected by HCEG Board members, advisors, and culled from leading industry research, 100+ forum participants held roundtable discussions over lunch to identify their specific table’s weighted top 10 items. The top ranking items from all tables were then combined to select the ten highest ranking items. Forum participants then ranked these items via a digital ranking process culminating in the official 2019 HCEG Top 10 list.
Our members expect the 2019 HCEG Top 10 items to have a significant and lasting impact in the way health plan members, health system patients, healthcare consumers, and other constituents all become engaged, digital consumers and responsible healthcare stakeholders in 2019 and beyond.
The 2019 HCEG Top 10 List
Data & Analytics: Leveraging data (especially clinical) to manage health and drive individual, provider and payer decisions.
Total Consumer Health: Improving members’ overall medical, social, financial, and environmental well-being.
Population Health Services: Operationalizing community-based health strategy, chronic care management, driving clinical integration, and addressing barriers to health such as social determinants.
Value-based Payments: Transitioning to and targeting specific medical conditions to manage cost and improve quality of care.
The Digital Healthcare Organization: HSAs, portals, patient literacy, cost transparency, digital payments, CRM, wearables and other patient-generated data, health monitoring, and omnichannel access/distribution.
Rising Pharmacy Costs: Implementing strategies to address the growth of pharma costs along with benefits to quality of care and to total healthcare costs.
External Market Disruption: New players like Amazon, Chase, Apple, Walmart, and Google.
Operational Effectiveness: Implementing lean quality programs, process efficiency (with new core business models), robotics automation, revenue cycle management, real-time/near-time point of sales transactions, etc.
Opioid Management: Developing strategies for identifying and supporting individuals and populations struggling with substance abuse/addiction or at risk of addiction.
Cybersecurity: Protecting the privacy and security of consumer information to maintain consumer trust in sharing data.
Highlights of the 2019 HCEG Top 10 List
Last year’s item #7 Healthcare Reform dropped out of the Top 10 but only by one place to number eleven. And last year’s tenth ranking item – The Engaged Digital Consumer – was supplanted by fifth ranking item The Digital Healthcare Organization.
New entrants to the 2019 HCEG Top 10 list include
#7 – External Market Disruption
#8 – Operational Effectiveness
Additional details and analysis of the 2019 HCEG Top 10 list will further explore the reasoning through facilitated discussions at upcoming events and within the HCEG digital community.
The Purpose and Value of the 2019 HCEG Top 10 List
The HCEG Top 10 List is used for two general purposes, each of which is intended to advance the healthcare industry’s move toward the Quadruple Aim of Healthcare.
#1 – Content Development & Programming
Serves as the basis for HCEG’s ongoing content development and educational programming opportunities throughout the year. Each of the Top 10 items is explored at various levels of depth and breadth throughout the year via:
In addition to guiding the overall thought-leadership, content development, and knowledge exchange initiatives throughout the year, HCEG’s Top 10 list is used as the basis for The Industry Pulse, a research survey sponsored by the HealthCare Executive Group and our sponsor partner Change Healthcare.
The Industry Pulse research survey is designed to gather additional insight on priorities and challenges facing healthcare industry constituents across the country and provide stakeholders across the healthcare spectrum real-world, actionable insight into near-term obstacles and opportunities. Combined, the HCEG Top 10 list and The Industry Pulse encourage continuous and evolving dialog on the main issues and concerns facing member organizations. Learn more about The Industry Pulse here.
More About the 2019 HCEG Top 10
Over the coming weeks and months, additional original and curated content based on the 2019 HCEG Top 10 will be shared. And the 2019 Industry Pulse research survey will take place. To stay in the loop and to learn more about the 2019 HCEG Top 10 and the HealthCare Executive Group, visit this page on our website and subscribe to our newsletter.
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.
Completing a successful core-system replacement project at a health plan or health system organization is a major undertaking. And successfully delivering a multi-million dollar digital transformation project is significantly enhanced by establishing a framework based on proven principles.
Framework for Successful Core-System Replacement Project
Last week, our sponsor partner Change Healthcare shared valuable insight in a webinar titled ‘The Four Pillars of a Successful Core-System Replacement Project.’ Jeanne Noe PMP, Director of Consulting Services and Mauricio ‘MJ’ Jimenez, Sr Manager of Consulting Services at Change Healthcare, shared information, insight and practical ideas on how to establish a framework for successful core-system implementation. This framework for a successful core-system replacement project is based on four pillars: 1-Implementation Readiness, 2-Governance, 3-Business Transformation and 4-Execution Framework.
This blog post recaps highlights and detailed content from the ‘Core-System Replacement Project’ webinar presented by Change Healthcare on August 2nd, 2018. Included is a recording of the webinar, the presentation slide deck, and additional information on establishing a framework for successful core system implementation. You can also check out this Twitter Moment summarizing live Tweets shared during the webinar.
Information, Insight & Actionable Ideas for Successful Core-System Implementation
After introductions by HCEG Executive Director Ferris Taylor, Jeanne Noe kicked off the webinar by sharing that the most important indicator of success in a Core-System Replacement project is a strong project foundation. Jeanne emphasized the importance of building a foundation on the Four Pillars of Success before the project progresses – not as you go along.
Why, How, What, Who & When of a Successful Core-System Replacement Project
The presentation from Change Healthcare was packed with information, actionable ideas and insight collected over the course of performing dozens of core-systems replacement projects for major healthcare payers and other risk-bearing entities.
Starting with the Taxonomy of Why, the importance of clearly defining – and widely sharing – the Strategic Vision, Business Goals, and Objectives were shared. Jeanne noted that explaining why a legacy system is being replaced is a key way to help all project team members achieve project objectives. Yet few healthcare organizations widely communicate the reasons for major initiatives like a core-system replacement project.
Jeanne went on to provide more details and commentary on the How, What, Who & When of a core-system replacement project. Since there’s simply too much information to share about the how, what, who and when in this recap, see the slides listed in the presentation deck for more. Better yet, watch the recording of The Four Pillars of a Successful Core-System Replacement Project here.
Roles Matters – Clearly Defined & Accountable
One of the most valuable bits of insight shared by Change Healthcare’s Jeanne Noe was that too many healthcare organizations make the very common mistake of not clearly defining roles, responsibilities and decision-making authority. Before the project starts – and periodically throughout the projects as objectives change and project resources come and go.
Clearly defining roles, responsibilities and decision-making authority seems obvious but is simply often not addressed.
Key Governance Components of a Successful Core-System Replacement Project
Change Healthcare presented two important actions healthcare executives sponsoring core-systems replacement projects MUST address at the start:
Establish a single point of accountability and expertise
Clearly identify decision makers and specialists for issue resolution
Risks, Actions, Issues, and Decisions – It’s a RAID!
Somewhat similar to the widely known RACI (Responsible-Accountable-Consulted-Informed) approach for managing large projects like core-systems replacement projects, Change Healthcare’s Core-System Implementation Framework uses the RAID framework to report, track, resolve and document project items.
As opposed to the somewhat passive activities defined via the popular RACI approach, Change Healthcare’s RAID approach to governing major projects emphasizes the importance of actions and rapid decision making within a framework of issue identification and risk management.
Business Transformation & Core-Systems Replacement Projects
Mauricio ‘MJ’ Jimenez, Sr Manager of Consulting Services at Change Healthcare continued the second half of the webinar by sharing information, insight, ideas, and tips on the 3rd and 4th Pillars of a Successful Core-System Replacement Project: Business Transformation and Execution Framework.
MJ emphasized that replacing your core-system is a business transformation, not an IT project or initiative. MJ offered the following as some key considerations to effect a true business transformation:
Assign senior resources to serve as ambassador to the rest of the organization.
Neglecting employees affected by the transformation will guarantee resistance to change.
Relevant content is key and its delivery is enabled through Role-Based Training
When meetings grow in number of participants, it is often a reflection of poor communication.
Execution Framework – The Most Critical of the Four Pillars
Core-system and other major projects undertaken by healthcare organizations will be for naught without a well-designed Execution Framework. Change Healthcare’s MJ Jimenez shared some key experiences, insights, and ideas on how to establish an effective Execution Framework. And offered ideas for executing brilliantly.
The key components of the Execution Framework described include the following:
Systems Integration Plan
Summarizing the Webinar
Jeanne Noe shared the following slide at the end of the webinar.As noted before, the information, insight, and ideas presented by Change Healthcare are too numerous to recap here. To learn more about what was shared during the webinar, check out the recording of the webinar, the presentation slide deck, and additional information on establishing a framework for successful core system implementation. Also, check out this Twitter Moment summarizing live Tweets from the webinar.
More Insight & Opportunity for HealthCare Executives
The information shared by the HealthCare Executive Group in its Webinar Series events are one example of services we’re pleased to offer our members and associates. In addition to connecting with us on Twitter, Facebook, LinkedIn and subscribing to our eNewsletter, consider joining other healthcare executives and industry thought leaders at the HealthCare Executive Group’s 2018 Annual Forum on September 12-14th, 2018 in Minneapolis, MN. We’ll be celebrating our 30th Anniversary helping healthcare leaders navigate the strategic and tactical issues facing their organizations.
Check out this page for more information on our 2018 Annual Forum.
The HealthCare Executive Group (HCEG) was honored to co-host a special Executive Leadership Roundtable May 9th at the recent HLTH Future of Healthcare Forum. HCEG partnered with the International Association of Innovation Professionals (IAOIP), the Center for Healthcare Innovation (CHI), the Workgroup for Electronic Data Interchange (WEDI) and special guest Dr. Sunnie Giles for the Boardroom-style event. The theme of the roundtable was Leadership, Trust and Skills in Overcoming Obstacles to Radical Innovation in Healthcare. Over a period of 3 hours, Charles Stellar, CEO of WEDI, moderated a panel of innovation and healthcare thought leaders as each shared their respective insight on the following topics:
Ferris Taylor, HCEG Executive Director, shared insights on innovation and technology gleaned from the HCEG member organizations, the HCEG Top 10 and 8th Annual Industry Pulse Survey
Brett Trusko, CEO of IAOIP, shared an International overview of Innovation Certification programs
Lynn Hanessian, Chief Strategist, Edelman Health representing CHI, shared info and highlights from the Edelmen Trust Barometer research, and
Dr. Sunnie Giles shared key findings from her research and recent book supporting “The New Science of Radical Innovation”
Insight into Obstacles to Radical Innovation in Healthcare
After each panelist concluded their presentations and key takeaways, an open Q & A period between panelists and attendees took place. This discussion evolved into an intimate engagement among Executive Leadership Roundtable attendees ensuing into a free-flowing, rather ‘un-conference-like’ approach. Interaction was so engaging that many session participants hung around AFTER the official end of the Executive Leadership roundtable to continue the discussion, network with each other and build professional relationships that are destined to accelerate more considerations in the future.
Insights on Radical Innovation in Healthcare – The HCEG Top 10 and 8th Annual Industry Pulse Research
Ferris Taylor connected the development of the annual issues to the common theme of innovation and technology and then shared five highlights of the 8th Annual Industry Pulse report – a survey of 2000 healthcare stakeholders jointly conducted by HCEG and its sponsor partner, Change Healthcare.
Social determinants of health have now transcended buzzword status
High-deductible health plans are not converting passive patients into active healthcare consumers
Mobile/digital health adoption is not just about functionality and interoperability, but is significantly impacted by privacy and security concerns – more about trust than technology
Industry attention is turning to blockchain, artificial intelligence, robotic process automation and other advanced technologies
Healthcare is transitioning from negative to positive incentives to influence consumer behavior faster than most expect
The Edelmen Trust Barometer
After Ferris Taylor set the context for key areas of need and innovation in healthcare, Lynn Hanessian shared a detailed overview of the Edelman Trust Barometer – a measure of people’s trust in business, government, NGOs and media. Lynn opened with a sobering chart showing a historical decline in trust over the period of 2017 to 2018 – with 14 of 15 sectors showing an overall decrease in trust.
Lynn also shared insight from the Edelman report showing the division of opinion as to the impact of Tech to the Cost of Healthcare: 23% of respondents believed that technology will make healthcare MORE expensive over the next 5 years and 16% believe technology will make healthcare LESS expensive.
Overview of International Innovation Certification Programs
Brett Trusko of the IAOIP shared an overview of how the IAOIP is on a mission to professionalize the practice of innovation around the world. Brett shared the following methods that the IAOPI believes will be critical to promote the IAOIP’s mission of advancing innovation:
Brett also shared an overview of the Current Body of Best Practices for Innovation, why ‘professionalization’ of innovation is important, his beliefs as to why Failure to Innovate is NOT an Option, He closed his presentation with What You Can Do Now to advance the professionalization of innovation.
The New Science of Radical innovation
Dr. Sunnie Giles rounded out the initial roundtable presentations by sharing some highlights from her new book “The New Science of Radical Innovation.” Sunnie shared:
A Definition of Radical Innovation
The Concept of VUCA (especially in healthcare): Volatility, Uncertainty, Complexity & Ambiguity
4 Factors That Make Radical Innovation Challenging for Leaders
How to Harness Volatility, Uncertainty, Complexity & Ambiguity to Increase Innovation in Healthcare
Open Discussion About Innovation at HLTH Future of Healthcare Forum
All in all, the Executive Leadership Roundtable at HLTH was an informative and engaging event. Of the 120+ registrants, over half participated in the roundtable with a number of walk-ins and with many of those individuals remaining afterwards to continue the discussion about the opportunities and challenges for innovation in healthcare. Given that the HLTH Association Day was the afternoon of the last day of the 4-day HLTH forum, all participants and presenters considered it a great success!
HCEG appreciates the collaboration with Brett Trusko from the Association of Innovation Professionals, Lynn Hanessian representing the Center for Healthcare Innovation and Dr. Sunnie Giles of the Quantum Leadership Group. HCEG would also like to extend a special thanks to Charles Stellar of WEDI for moderating the panel and representing WEDI’s role in innovation and technology so well.
Connect with Each Other and The HealthCare Executive Group
If you enjoyed the 2018 HLTH Future of Healthcare Forum, or would like to participated in a greatly scaled down yet equally valuable version of the forum, consider being part of the HealthCare Executive Group’s Annual Forum taking place in Minneapolis, MN on September 12 – 14th. We have a special event planned to celebrate our 30th year anniversary. Moreover, if you’re a healthcare executive who can benefit from collaborating with your C-suite peers, consider becoming a HCEG member.
The inaugural 2018 HTLH Future of Healthcare forum took place in Las Vegas earlier this month with 3,500+ attendees and 375+ speakers assembled over four days starting May 5th with the HLTH Hackathon. And HealthCare Executive Group (HCEG) members and sponsor partners were there – interpreting and absorbing key takeaways, presenting as speakers and panelists in various sessions and adding their own unique support and participation at this highly touted, new healthcare conference billed by organizers as ‘The Hottest, Newest, Largest and Most Important Healthcare Event.”
Sessions at HLTH were organized into five tracks that varied each day. So, with 100+ sessions over four days, there were about 4 or 5 sessions covering any particular track – a reasonable and manageable number. HLTH event organizers also assigned all sessions in each track to the same room location; making it easy to navigate between tracks and sessions. There were a few crowded sessions and some rather sparsely populated sessions.
Based on an informal survey of sessions attended by HCEG members and a scan of various recaps of the HLTH Future of HealthCare forum over the past two weeks, a few common threads emerged.
Must Address Multiple Conditions, High-Cost Patients & Care Transition
Many of the sessions at the HLTH event addressed the importance of providing cost-effective services and products to three groups of people:
People with multiple chronic conditions – particularly diabetes, hypertension, hyperlipidemia, asthma and depression.
Patients who drive a large percentage of total health care costs
Patients discharged from the inpatient setting.
Health Happens Outside the Exam Room & Hospital
And many of these same sessions and more than a few of the exhibitors shared information, ideas and approaches aimed at addressing these three populations by focusing on social determinants of health. Quite a few speakers and panelists spoke of the need to extend health services beyond the walls of the treatment room and out into the local community.
As noted in the recent Industry Pulse Research Survey co-authored with HCEG sponsor Change Healthcare, payers are beginning to integrate community programs and resources into their medical practices. Only 18.9% of responders said they were not currently integrating any social determinants of health, a dramatic change over the last few years.
Payment Innovation in Healthcare is Desperately Needed
Another oft-mentioned topic at the HLTH forum was value-based care and the need for payers and providers to come together on sharing not only upside risk but downside risk as well. While the rise of personalized medicine, targeted therapies, specialty pharmaceuticals and molecular diagnostics offer tremendous opportunity, payers are still growing their sea legs figuring out how to measure outcomes and associated value models – at the same time as providers and the healthcare supply-side are beginning to demonstrate outcome values in risk-based payment contracts.
What’s clear is that rapidly evolving medical technologies must be simultaneously supported by reasonable regulatory frameworks and payment model development. Hopefully, the federal government will serve as the vanguard for innovation in the area of reimbursement.
Engagement: The Most Un-Buzzworthy Word at HLTH?
In one session, the moderator quizzed the panel as to what industry buzzword they disliked most and ‘engagement’ was the clear winner (loser?) among panelists as the most over-used and unclear healthcare buzzword. The CEO of Maestro Health, Rob Butler suggested that people don’t want engagement with a medical condition but rather to be connected to their health system and support networks.
HCEG Members & Sponsors at the HLTH Future of Healthcare Forum
More than a few of our HCEG sponsor partners were at the HLTH event – speaking in sessions, as sponsors, participating in 1:1 and small group meetings and exhibiting.
Softheonwas active in several ways with sponsoring the HACK/HLTH ‘hackathon’ where participants collaborated and created meaningful solutions in competition for over $80,000 in prizes. Eugene Sayan, Softheon’s CEO also presented ‘Convergence of Health and Non-Health Data’ along with Jeff Margolis, CEO of WellTok.
Not to stop with those two events, Softheon also joined Lyft to sponsor Wyclef Jean at the JEWEL Nightclub on Tuesday. Softheon also was one of the larger exhibitors at the HLTH Future of Healthcare forum. Check out pictures of HLTH’s After-Hours Activities here.
Change in Healthcare at the HLTH Future of Healthcare Forum
Change Healthcare’s President and CEO Neil de Crescenzo keynoted Tuesday’s General Session “The Patient Experience: Making it Easier for Healthcare Providers to Make it Easier” and shared some common-sense solutions to revolutionize patient experiences, utilizing healthcare data in ways which enable providers to orchestrate and improve patient interactions – all while delivering a seamless experience aimed at improving patient loyalty and new patient attraction.
Change Healthcare was also a major sponsor, giving the first 3,000 attendees a high quality hot/cold mug and having a dominant position in the Exhibit Hall. Change HC also teamed up with Adobe and Microsoft to “Put the ‘Consumer’ in Healthcare Consumer Engagement.” enable health systems to better engage with patients. The joint solution will use Change Healthcare’s Intelligent Healthcare Network, Adobe’s Experience Cloud, and Microsoft’s Azure offering to improve customers’ healthcare experience. You can learn more about this venture here.
CareCentrix CEO John P. Driscoll was a panelist along with David Muhlestein, Chief Research Officer at Leavitt Partners on a Tuesday session titled ‘Aligning Health Policy to Health Possibility.’ This session addressed the potential for technology to transform the health industry through more innovative – and perhaps disruptive – health policy. There were a few moments of ‘extreme interaction’ between the two panelists.
HealthEdgesponsored one of the few handfuls of ‘Meeting Pods’ at the HLTH event. These small group meeting spaces along the hallways seemed like a good idea and through focused effort, HealthEdge had it pod occupied to clients and prospects during the entire HLTH event.
Announcements at HLTH2018 – Large, Small & Mostly Meaningful
One of the interesting media related events at the HLTH event was the “Make an Announcement” opportunity for all HLTH attendees. All sponsors, exhibitors, speakers or otherwise were able to make an announcement about new products, venture funds being launched, collaborations and other ‘newsworthy events’ at a pre-arranged time in a dedicated media area. Some of the major announcements included:
Funding Founders – 6 Minute, Double Opt-In VC ‘speed dating/networking session’ took place about 300 times early in the day for one hour. Based on the early morning start time and lively attendance, the Hosted Buyer and Funding Founders sessions seemed like worthwhile features of the HLTH forum.
Great Meal Service – The HLTH organizers offered a nice selection of good food, well-orchestrated for a conference of this size
Digital Content Delivery, Networking and Logistical Support at the HLTH2018 Forum
In a future post we’ll share some insight and opinion about some of the unique ways in which the HLTH Future of Healthcare Forum organizers differentiated their forum and provided extra value opportunities to attendees.
HLTH 2018 Association Day: Executive Leadership Roundtable – HCEG, CHI, IAIOP and WEDI
As noted above, HCEG was honored to join other associations in an Executive Leadership Roundtable (ELR) as part HLTH’s 2018 Association Day. The theme of the ELR was centered on leadership in healthcare innovation and complimented by author Dr. Sunnie Giles highlighting her just published book on “The New Science of Radical Innovation.” Look for a recap of the roundtable as part of HLTH’s Association Day in a following post.
Ongoing Press Coverage of the 2018 HLTH Future of Healthcare Forum
Given that it’s been a couple weeks since the HLTH Future of Healthcare forum has ended, you can imagine there are a number of other recaps like this one from The HealthCare Executive Group. Here are additional recaps of the HLTH Future of Forum currently available:
More Insight and Ideas on Events for Healthcare Executives
Check back soon for more on the 2018 HLTH Future of Healthcare Forum. We’ll provide a detailed recap of the Executive Leadership Roundtable event that took place on Wednesday, May 9th.
Before the month is out, the HealthCare Executive Group will be opening up registration for our Annual Forum taking place in Minneapolis, MN on September 12 – 14th. We have a special event planned to celebrate our 30th year anniversary. If you’re a healthcare executive who can benefit from collaborating with your C-suite peers, consider becoming a HCEG member.
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:
Enhancing patient experience
Improving population health
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.
This blog post provides an overview of webinar highlights of the discussion between Kim, Ferris and David, their responses to attendee questions and some additional information to be shared in a future blog post. The webinar presentation materials and a recording of webinar can be found here.
Note: Verbatim responses are included in quotations and paraphrased responses are not quoted.
Topic #1: Most Interesting Items on 2018 HCEG Top 10 List
Kim asked David and Ferris which three items on the 2018 HCEG Top Ten list three areas were of most interest?
“Of course, they’re all very interesting to me. It’s been a very much a part of my life for the past few years being involved in Healthcare Executive Group and obviously being part of the industry. But really, I think the top three on the list are the top three for a reason. I look at these as the three pillars of value-based care.”
“Any value-based program needs to ensure that it’s that it’s a win-win-win for the payer, for the provider and for the member, in order for it to be sustainable. So, in order for it to be a win-win-win, you really need these three pillars. You need alignment and financial incentives. You need to have strong payer provider integration, or cooperation really, to create a true partnership between the caregiver and the payer. But you also need to have the provider and the payer partner on fundamentally changing the way care is delivered.”
“I don’t think we should minimize the topic of costs in healthcare and that probably shows up in the Top Ten most significantly around Cost Transparency (Item #4). A lot of that discussion in the recent months has been around Addressing Pharmacy Costs (item #9) but it’s not exclusive to that.”
“But here in the HCEG Top Ten is also cyber security (Item #6) and it’s interesting to me that it – like the clinical data and analytics (Item #1) you mentioned David – cuts across almost all of the issues. If we can’t assure the consumer of some sort of privacy around their data and some security, then we have an issue. Cybersecurity was not on the HCEG Top Ten list for many years going back. Three or four years ago it came up to the top of the list.
My top three would also have to include that bigger bucket of consumerism. It’s on the list as Total Consumer Health (Item #5) and Harnessing Mobile Health Technologies (Item #8). And also, The Engaged Digital Health Consumer (Item #10).
“We are in a major transformation of healthcare from the consumer to the buyer being the employer to the consumer. So, I would add those three Kim to the list that David has pointed out.
Keeping Track of David’s & Ferris’s Top 3 Top 10 Picks?
David Gallego’s Top 3 Picks
Ferris Taylor’s Top 3 Picks
#1 – Clinical and Data Analytics
#5 – Total Consumer Health
#2 – Population Health Services Organizations
#8 – Harnessing Mobile Health Technology
#3 – Value-Based Payments
#10 – The Engaged Digital Consumer
Topic #2: Healthcare Consumerism
Kim asked Ferris and David to give their perspective on consumerism and what they’re seeing in the industry absolutely?
“So fundamentally, I think consumerism is about giving people what they want. So, at a high level that means affordable, accessible high-quality care that improves their overall quality of life. That’s simplistic in some ways but I think everyone could agree that’s what people want of health care. You must look at a more granular level as to what consumers want and need as they can vary significantly. And then, so from that perspective, consumerism really needs to be about customization.”
Customized care means the right service and/or right content is delivered at the right time, at the right place and by the right caregiver.
It’s about 24-hour access to care.
It’s about multi-channel access to information and services.
It’s about providing relevant content to current or predicted life events.
It’s about customized care plans to take individual patient specific conditions, genomic, social determinants all into consideration.
It’s about empowering and enabling the consumers so they have the right amount of information to make the right decisions for their health, cost, and quality etc.
“There’s a lot of dimensions of the cost equation, of the price equations that our health care consumers, our members, and our patients just don’t understand. It isn’t consistent with what they experience in the other aspects of their life and I think that takes me to the consumer discussion. And that’s clearly one of my top three.”
“But we are in a major transformation of healthcare from the employer being the buyer to the consumer being the buyer. In December, the American Health Insurance Plans (AHIP) association had an entire three-day conference on consumer experience and digital health. In a nutshell, it really stuck in my mind that as health plans, providers and technology vendors really need to stop thinking like health plans, providers and technology vendors; and start thinking like consumers. People don’t look at healthcare as the only thing in their lives.”
“It’s our responsibility as healthcare stakeholders to find a way that our healthcare messages and our healthcare initiatives can fit into the life flow of our members and our patients; and that of their families, their work, their community and what we need to weave into our initiatives the day to day things that we know, if consumers did them.”
Analogy About Healthcare Spending by David Gallegos
David shared an interesting, very accurate and rather amusing analogy about healthcare spending. “$16 Worth of Groceries for $10!”
Topics Addressed in Next Post: Cybersecurity & Rising Pharmacy Costs
The above represents just a small portion of what Kim, Ferris and David discussed in the first half of the webinar. For more insight on any particular area of interest, you can watch the webinar recording and/or read the transcript here.
In a following post, highlights from the second half will be shared. These include responses to the following two topics posed by Kim Sinclair to Ferris Taylor and David Gallegos:
How are you seeing cyber security and cyber threats impact healthcare organizations beyond the tactical day-to-day front prevention activities?
What are your thoughts about what we as healthcare leaders can do about rising pharmacy costs?
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:
Collaborating with providers and health systems
Partnering with community resources
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:
Access to Healthcare Services
Access to Food
Access to Local Community Resources
Access to Transportation Options
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:
Be methodical about population assessment
Integrate People, Process and Technology with Providers
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.
The 29th Annual Forum of the Healthcare Executive Group held in Nashville last week included nine sessions lead by healthcare industry leaders. These industry veterans and thought leading panel members provided forum participants with a wealth of information and insight into key areas of healthcare reform, innovation and digital transformation. As might be expected, insight, ideas, opinions and concerns surrounding the areas of Consumer Engagement, Transparency, Population Health, Health Plan-Provider Data Exchange, and Merger & Acquisition activity within the digital healthcare space were common across nearly each of the nine sessions presented at the forum.
As noted in this previous post, content from these sessions will be shared over the coming days and weeks. In this post, highlights from each of the above referenced areas shared by forum participants via social media are presented. Special thanks to all those who shared via their social channels. To receive other information shared during our 2017 Annual Forum, consider subscribing to our newsletterand following us on our social channels: Twitter, LinkedIn and Facebook.
“Need time to develop trust w/ others; it typically takes 30 days of near daily engagement.” – Rich Rakowski of Medically Home
“Coins term ‘Co-vider’ where healthcare consumer serves as 1st provider identifying (diagnosing?) medical condition.” – Steve Sisko @ShimCode quoting David Vinson of @DHXGroup
“We’re trying to put the pharmacist in front of the counter – to more easily interact with consumers.” – William Resnick of EmpiRx Health
“Many health plans have lost sight that they’re essentially a community of people that must be regularly engaged.” – Torben Nielsen @TorbenSNielsen of Premera
“Near unanimous consensus by participants that technology is not the problem; rather policy, inertia & politics.” – Steve Sisko
“What’s your one ‘dashboardable metric?” Rich Rakowski: “A 30-50% savings for the payer for patient condition.” – Ben Leedle of Blue Zones, LLC asking “What was Missed in Two Decades of Population Health – Today’s Opportunities for Disruptive Innovation” panel
“Cognitive behavioral therapy is becoming first line treatment for insomnia; not drugs.” – Joe Jennings, CEO at BeHealth Solutions @behealthsolns
Social Determinants of Health
“Katrina lesson: sensitive extreme collaboration. Social determinants become real.” – Chuck Martel @cmartel on Dr. Karen DeSalvo keynote
“Our zip code affects our health more than our genetic code.” – Richard Lungen @rlungen of @Leverage_Health quoting Dr. Karen DeSalvo
“Healthcare spend and trend is crowding out other essential social investments. Agree?” – Mark Stryker on Dr. Karen DeSalvo keynote
Accountable Care Organizations
“First step to ACO success: providers and payers agree to ‘put down their weapons’ with data.” – Chuck Martel quoting John Poelman @JHPoelman of Leavitt Partners @leavittpartners
“Panelists note there is no clear correlation between #ACO financial results and quality measurement outcomes.” – Steve Sisko quoting panelist in “Value-Based Reimbursement/Relationships” session
“Data is the single most important element we’re just beginning to exploit.” – Chuck Martel quoting Torben Nielsen in “Healthcare & Consumers Going Digital – Is HIT a Disruption or Opportunity?” session
“The unabated proliferation of healthcare apps is “Appageddon.’” – Steve Sisko quoting David Vinson
“I work in healthcare during the day. And then I go home to the 21st century.” – Torben Nielsen
“Technology and Technology companies’ are re-creating what health looks like.” – Mark Stryker paraphrasing Dr. Karen DeSalvo keynote
Transparency of Price & Quality
“Need to differentiate between price transparency & transparency of clinical efficacy & potential interactions.” – Blake Slansky of Walgreens
“Are we going to try to compete w/ Amazon on cost? Or quality of service? How will we protect our position?” – Forum Attendee asks panel addressing “Pharmacy Costs / PBM and Rx Transparency”
“Only two countries allow Direct to Consumer marketing of prescription drugs: United States & New Zealand.” – Nichole (Nikki) White of Medica
Mergers & Acquisitions in Healthcare
“What are some of the things that are going well or not so well in healthcare M&A?” – Justin Roth of Triple Tree Investments @TripleTreeLLC asks “Technology Innovation and M&A Market Trends” panel
“Need to move cultural due diligence upstream in the M&A process.” – Tom McEnery of Change Healthcare @Change_HC
“Having a designated liaison for each functional area. And be sensitive to culture of each area.” – Paul Wallace of Heritage Group USA
Plan Provider Data Mgmt
“Providers view data updates as a misplaced burden & something that disrupts patient care.” – Charlie Falcone of Aperture Credentialing during “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panel
“The proliferation of networks – especially ACO’s – has exacerbated provider directory data accuracy issues.” – Ian Gordon of Regence/Cambia Health Solutions @Cambia
“Working w/ data originators to co-develop data exchange processes vs. dictating requirements can improve data.” – Ian Gordon
“Differing state regulations & mandates hamper ability to develop shared plan-provider data mgmt processes.” – Steve Sisko paraphrases Charlie Falcone
“Provider data management is not a strategic act but an ongoing tactical & operational activity.” – Russ Thomas of @Availity
“Plan-provider data management is not a technology problem; it’s an engagement challenge.” – Ian Gordon
“Health plans generally don’t view provider data management as an area where they need to compete.” – Russ Thomas
“Panel members all agree that #ACA should have mandated plan-provider data requirements, standards & update processes.” – Steve Sisko paraphrases “Payer Provider Operations – CMS Mandates & Provider Data Management Initiatives” panelists
“Fail to succeed…glean something from every mishap and mistake.” – Donato Tramuto (Via @Tivityhealth)
“Core competencies are transferrable. Don’t confuse what people do with what they are good at.” -Tom McEnery
There’s More Coming!
We’re just getting started with sharing content from last week’s 29th Annual Forum of the Healthcare Executive Group. We’ll be sharing recaps from individual sessions, participant interviews, pictures from the forum and more. So stay connected and in the loop bysubscribing to our newsletterand following us on our social channels. Better yet, consider becoming a membertoday!