3PHealth Blog
To Control Costs You Must Control Claims
Thursday, November 17th, 2016
In today’s ColoradoBiz digital magazine, Andrew Neary wrote this thoughtful article on self-insured businesses. He discusses what companies can do to ensure that their goals for lower insurance costs and healthier, more productive employees are actually achieved.
My blog title is a quote from his post. It gets to the heart of what many of us can do, right now, to help solve the problem of rising healthcare costs:
WE CAN MAKE IT EASIER FOR PEOPLE
TO STAY HEALTHY OR KEEP EXISTING CONDITIONS FROM WORSENING
In this time of regulatory uncertainty, it’s easy to simply wait and see what happens next year. But that doesn’t help anyone. There are things we can do right now that can improve the health of our citizens. As businesses and care delivery organizations, we have the ability to align our interactions and incentives with the behavioral changes and outcomes. While, we have begun this process, but still have a long way to go.
The first step on our journey to physical and fiscal behavior change is to acknowledge the current state of healthcare:
- The majority of reimbursement is not tied to health outcomes
- Lack of pricing transparency is counter to consumer decision processes
- It’s easier to manage symptoms than change the causal lifestyle behaviors
- Some stakeholders make more money managing conditions vs. curing them
- PCPs do not have enough time to actively engage patients in lifestyle changes
- Leisure and work time is increasingly tied to screens, instead of balls and boots
- Our food choices are driven by convenience and profits over health and nutrition
While these issues are too big for any one organization to solve, we can all consider them as we define our strategies, products and services. We can focus on what we can do, instead of what we cannot, or may not be able to do in the future:
- Technology dramatically improves our ability to help patients navigate the health system and make better choices.
- We can partner and engage in ways that support the alignment of incentives and the desired health and financial outcomes for all the stakeholders.
- We can enable new ways to engage people on their terms, and then analyze the data from these interactions, to adjust and adapt our policies, processes and care delivery strategies.
Let’s focus and take action on what we know works. We can’t afford to wait any longer. People who engage in their health make better health decision and reduce the cost of healthcare – for everyone. So let’s make it easier for that to happen.
IT as a Strategic Partner in Clinical Outcomes
Wednesday, November 2nd, 2016
Over the past 18 months, there have been numerous articles by the big consulting firms touting the importance of IT partnering with business units to play a more strategic role in the organization. With technology becoming integral to everyday business processes and to creating a differentiating user experience, common sense tells us this is true.
But what about healthcare? Can IT actually impact clinical outcomes? We believe it can, and it was nice to see this article from Health Data Management talk about the changing roles of healthcare CIOs and CMIOs.
I have spent my life working with brilliant, creative and driven IT professionals. The best of them have helped me to think bigger and see what is possible, not avoid what is hard or uncomfortable. So, when I enthusiastically dove headfirst into healthcare, I was surprised to run into passive IT organizations. They looked to their EHR vendors to tell them what their strategic IT “roadmap” would be for the coming year. No other industry would let a vendor dictate their strategy.
So why is healthcare different, particularly when the health and financial costs associated with this approach are staggering?
Historically, health IT (outside of the OR, ER and imaging) was about billing. Then came the EHR. Adoption has been difficult and all consuming. We got tunnel vision. We were overwhelmed with compliance and penalty avoidance and lost clear sight of how our customers (patients and providers) want to engage with us.
More recently many health systems jumped on the mobile band wagon, but sustained use is limited and clinical impact is rarely measured. For most organization, it was a reactive tactic vs. a strategic initiative. So now, IT finds itself resetting its strategic course. Which means it’s a great time to partner with the rest of the organization to improve the user experience, health outcomes and financial health.
It’s time to strategically transform care delivery systems. Systems that improve health outcomes, profits and sustainability. Be it virtual care or virtual reality. Remote monitoring or remote access. Connecting doctors, connecting patients, connecting information. CIOs and CMIOs are in the unique position to help clinicians explore the myriad ways to simplify connections between people, and between people and content. They can also guide EHR vendors towards more open, modular solutions that can adapt to their strategies, and not the other way around.
IT is filled with creative people and strategic thinkers. They are also in the unique position to help envision and deploy care delivery systems that make it easy for patients to comply with their care plans and collaborate with doctors and peers in support of improved health outcomes. Outcomes that can directly impact your organization’s bottom line.
Help your teams leverage the hundreds of innovative new m-health and e-health products and services that can make interacting in their health more effective and pleasurable. Weave in solutions that can help analyze, diagnose, remotely monitor, and engage patients in their care. Strategies that can simplify collaboration and virtually extend care teams. Give patients access to the “right” care and information, just when they need it – making it easier and more convenient to reach a doctor, nurse or mental health professional.
It’s time to view compliance and privacy as opportunities and not barriers. The offer new ways to connect people and share information within a rich digital health ecosystem. We are only limited by our imagination and willingness to do what is right for all of our stakeholders – the patient, the provider and the payer.
Inclusivity Leads to Innovation
Wednesday, August 10th, 2016
While this post does not directly speak to digital care issues, it is relevant to the topic of innovation. I am actively involved with Prime Health community here in Colorado. As a co-chair of the Inclusivity working group, we are always searching for information and resources to help our members maximize creativity, innovation and productivity through inclusive business practices.
This recent Massachusetts employment legislation, as reported by the NY Times, highlights one way in which we can all contribute to innovation by becoming more conscious of our cultural biases. From the article:
By barring companies from asking prospective employees how much they earned at their last jobs, Massachusetts will ensure that the historically lower wages and salaries assigned to women and minorities do not follow them for their entire careers. Companies tend to set salaries for new hires using their previous pay as a base line.
“I think very few businesses consciously discriminate, but they need to become aware of it,” said State Senator Pat Jehlen, a Democrat and one of the bill’s co-sponsors. “These are things that don’t just affect one job; it keeps women’s wages down over their entire lifetime.”
Is your company asking your job applicants to share previous salary information as part of your hiring process? If so, you may be perpetuating the pay equity problem. Remember that minorities must be put in the context of the industry or job function – which could be men in positions such as nursing or early childhood education. This data does not just apply to women, age and ethnicity.
Let’s not wait for Colorado to pass a law in order to stop the cycle and do the right thing. It’s up to us to build Colorado’s digital health ecosystem based upon respect and equality. Simple changes in process or policy can go a long way to increasing our innovation and competitive edge as companies, health organizations and a digital health community.
Is it Time to Update Your Care Delivery Strategy?
Saturday, August 6th, 2016
The costs of care delivery continue rise, even in the face of new technologies designed to enable telemedicine, or virtual care delivery. Some of this is due to the cumbersome nature of certain tools and poorly conceived incentives, but the fear of change relative to both clinical processes and reimbursement impact, keeps many provider groups from embracing the virtual approach to improving clinical efficiencies.
Local physician, turned entrepreneur, Arlen Meyers M.D. is an outspoken proponent of overhauling care delivery in support of better health and financial outcomes. In a recent article entitled, Stop the Unnecessary Medical Visits, Dr. Meyers presents several cases for why it’s time to seriously consider making this strategic shift.
…However, there are many other reasons, like defensive medicine or perverse financial incentives, that add to cost and inconvenience and are wasteful and unnecessary.
Embracing virtual care improves clinical efficiencies and can reduce the overall cost of care for providers, payers and patients. It’s time to reconsider when and how we connect with our patients. Technology has become far less of a limiter than the human factor. It’s time to formulate and execute upon a care delivery strategy grounded in convenience – accessible to everyone. It should be supported by technology designed to connect patients to the most cost-effective care delivery channel based on their changing, individual needs and health condition. k
Best to be our own agents of change, retaining strategic control of both care delivery and business strategy that benefits patients, providers and payers. The alternative is waiting for regulation to force us into a less than ideal care delivery model.
How Will You Invest in the Future?
Thursday, June 9th, 2016
This blog is from a great local physician decision support company, Medaware Systems. I was struck by the impact a single investment decision by a health organization can have on so many people.
http://www.medawaresystems.com/one-hospital-invested-tens-millions-preserve-community-won/
It highlights the power of innovative thinking and what health systems can do to impact their communities (and themselves) in a positive and sustainable way.
Innovation comes in many forms, but in all cases it is based on creative, out-of-box thinking and a long-term strategic view with both financial and “community” health outcomes in mind. Technical innovation is only as good as the strategy behind it and the commitment to execute in a meaningful way.
Think differently about your strategy and technology decisions. Dare to dream, and make it happen!