Recapping ‘The 2018 HCEG Top 10 Healthcare Opportunities, Challenges & Issues’ Webinar – Part 1

By | Top 10, Value-Based Care, Value-Based Payment, Webinar Series | No Comments

Last week we kicked off the first entry in the Health Care Executive Group’s 2018 Webinar Series: The 2018 HCEG Top 10 – Healthcare Opportunities, Challenges & Issues. The new board chair of HCEG, Kim Sinclair, CIO at Boston Medical Center Health Plan, moderated the webinar and was joined by Ferris Taylor, HCEG’s Executive Director and Consultant to Arches Health Plan and David Gallegos, Sr VP of Consulting Services at Change Healthcare,  one of HCEG’s long-time sponsor partners.

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?

David:

“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.”

Ferris:

“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 PicksFerris 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?

David:

“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.

  1. It’s about 24-hour access to care.
  2. It’s about multi-channel access to information and services.
  3. It’s about providing relevant content to current or predicted life events.
  4. It’s about customized care plans to take individual patient specific conditions, genomic, social determinants all into consideration.
  5. 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.

Ferris:

“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?

Connect with the HealthCare Executive Group

If you want to learn more about healthcare in the United States and connect with like minded thought-leaders, consider subscribing to our eNewsletter, follow us on Twitter, and connect with us on LinkedIn and Facebook. Better yet, join our unique organization of healthcare executives and thought leaders.

Healthcare Executive Group’s 2017 Annual Forum – Social Media Highlights

By | Annual Forum, Executive Leadership Forum, HCEG Top 10, Healthcare Reform, The Industry Pulse | No Comments

healthcare executive group hceg digital transformation annual forumThe 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 newsletter and following us on our social channels: Twitter, LinkedIn and Facebook.

Consumer & Patient Engagement

“Doctors working at the ‘Top of their license’ will address most of the provider shortage.” – Mark Stryker @themarkstryker of @Leverage_Health quoting Dr. Karen DeSalvo @KBDesalvo

“We’re working w/ our retail pharmacy partners to help them to better help consumers.” – Jim Sheninger of @GoodRx

“Engagement starts w/ developing culturally sensitive trust of providers treating patients.” – Hugh Lytle @equalityceo of @EqualityHealth1

“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

Population Health

“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

HCEG Annual forum healthcare executive group healthtechSocial 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

Digital Health

“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

hceg annual forum digital health annual forumPlan 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

Innovation

“Innovation without integration will not yield sustainable results.” – Donato Tramuto @DonatoTramuto of Tivity Health @TivityHealth

“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 by subscribing to our newsletter and following us on our social channels. Better yet, consider becoming a member today!

Opportunities, Priorities & Challenges Facing Healthcare in 2017

By | Healthcare Reform, The Industry Pulse, Top 10, Uncategorized | No Comments

The HCEG Top 10 list of healthcare priorities, challenges and risks faced by healthcare industry executives is developed each year at HCEG’s annual forum. For the past seven years, the HCEG Top 10 list has served as the keystone for industry wide analysis, and subsequent research: The Industry Pulse, an annual survey initiative, conducted over the past seven years in partnership with Change Healthcare – a sponsor partner of the Healthcare Executive Group.

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.

The 7th Annual Industry Pulse Research Survey

On March 29th, a webinar provided an overview of highlights from The Industry Pulse was shared here to help industry leaders better understand the current healthcare environment, as well as to prepare for, and navigate, change. The webinar offered an initial interpretation of research survey results across the following topic areas:

  • The Current State of Clinical & Data Analytics (HCEG Top 10 Item #3)
  • Privacy & Security in a Data Driven Environment (HCEG Top 10 Item #4)
  • Customer Service: Cost vs Quality Transparency (HCEG Top 10 Item #5)

This post presents a recording of that webinar including the entire slide deck presentation and an infographic presenting some key findings from the 7th Annual Healthcare Industry research survey.

Webinar Recording

Presentation

Infographic

Healthcare industry insight recording healthcare industry pulse presentation deckhealthcare industry pulse infographic

More Insight, Trends & Analysis

Over the following weeks and months, additional analysis and insight will be gleaned from The Industry Pulse and shared by HCEG and Change Healthcare. To stay abreast of the unique insight offered by the Healthcare Executive Group, the HCEG Top 10 list and The Industry Pulse research survey, be sure to subscribe to our newsletter and follow HCEG on Twitter, Facebook and LinkedIn.

Using Incentives to Drive Health Care Shopping Behavior – Recap, Recording & Research

By | 5-Transparency, Sponsor, Top 10 | No Comments

On Tuesday, December 13th, HCEG sponsor HealthSparq presented a webinar on “Using Incentives to Drive Healthcare Shopping Behaviors.” Over 100 individuals and companies registered for the webinar presented by John Surie of M Health and were presented with information from a study commissioned by HealthSparq to explore how how incentives can impact health care shopping behavior.  The graphic-laden presentation offered insight into information that could influence how incentives programs are rolled out by health plans, employers and health systems.

Healthcare Cost Quality Transparency Consumer Shopping Behaviors

Research Survey on Use of Incentives to Drive Healthcare Consumer Shopping Behaviors – M Health/HealthSparq

Some Survey Highlights Include

  • Examples of popular “incentives” include lower premiums, reduced co-pays, cash, gift cards, movie tickets, etc.
  • Cash incentives are most effective but smaller amounts are almost as effective as larger amounts
  • Providing an incentive of some sort has a marked increase (20+%) in encouraging the use of telehealth services
  • Incentives have a strong positive impact on encouraging the viewing of healthcare-related videos Increasing the amount of an incentive had strongest effect in driving choice of a surgical center
  • Cash incentives have a stronger influence on choice of lab & imaging than on choice of physician, which entails a more personal decision.
  • Heavy ‘users of incentives’ were not any more likely to achieve positive outcomes vs. light users
  • Strong correlation btw those who use ‘rewards programs’ outside of healthcare (airlines, grocery, etc.) and reward programs in healthcare

The Recording, The Research and More Insight from HealthSparq

In addition to making a recording of the webinar available here on YouTube, HealthSparq created a summary of the webinar via this blog post. Moreover, HealthSparq is willing to provide speaker John Surie’s complete research paper on the topic presented in the webinar. You can request that research paper here.

If you have any questions about using incentives to drive healthcare shopping behaviors or would like to obtain additional information , please reach out to HealthSparq at 855-SPARQ-IT (855-772-7748) or via their web site. You can also follow @HealthSparq on Twitter.

More for HCEG Members

For the 2017 membership year, HCEG has many additional opportunities for learning, sharing and networking with other healthcare industry executives, opinion leaders, and decision makers. If you’re not a HCEG member and would like more information on becoming a member, please see https://hceg.org/membership/ or contact Juliana Ruiz at [email protected].