Tuesday, April 19, 2016

Do Health Plans Provide Any Value? Of Course They Do!

Image via Insperity.com 
Today’s post on Forbes titled Health Plan Industry's Worst Nightmare: Employers Realizing They Are Actually The Insurance Company by serial entrepreneur, healthcare luminary, and social media blogger Dave Chase - and I lend that last ‘blogger’ label with the utmost respect – seemed like something I should read. After all, I’ve labored in the health plan, healthcare payer and risk-bearing provider space for over 20 years. But what really caught my eye was the byline “what do health plans do that couldn’t be done better by an algorithm?”

Dave asks himself four questions apparently intended to solidify his stance that health plans don’t provide any value. Yet even before Dave asks one of those four questions Dave states that “self-insuring and working with TPAs is appealing to many companies.“  This post of mine posits questions back to Dave on each of his four questions.


For the Record - ‘Quadruple Aim’


Do health plans improve the care team experience?
I ask: Are doctors the only members on the ‘health care team?’ How many of the ‘bureaucratic services’ that wear out doctors are due to federal and state regulations? Certainly self-insured plans can circumvent many of those regulations. But for how long?

Do health plans improve the patient experience?
I ask: Similar to ‘care team experience,’ how much of a patient’s experience do health plans have direct input on? I think it’s misleading and presumptuous to reference Net Promoter Scores (NPS) when the majority of healthcare consumers have little skin in the game, are generally perspicacious with little ability to choose based on cost and quality - until just recently, and aren’t the ones making people wait, oft times rushing a patient through an encounter and then leaving them on their own largely responsible for 'patient experience?'

Do health plans improve outcomes?
I ask: What’s your definition of an ‘outcome?' What does a provider do that serves as a means to measure a good outcome? Over the last 35+ years I've had quite a few experiences with providers who HAVE NOT provided 'good outcomes' - at least in terms of the value I received for the large amount I had to pay them. But I was still on the hook to pay them. How come?


Indeed, until recent years, I don’t think I’ve ever had much information, opportunity and/or support to be someone who could intelligently contribute to a Net Promoter Score. Not to sound 'elitist' but as a parent of four 'millennials' I feel I've had more than my fair share of opportunities. Is being 'called on the phone' by a health plan or a provider a good measure of value received. Indeed I don’t think I’ve ever been called by any of the ‘major service or product providers’ that are a significant part of my life:’ – utilities, banks, grocers, auto makers, mortgage companies, etc. – unless I owe them money. Is it fair to single out health plans? I don’t know much about NPS so maybe it is?

Do health plans lower costs?
I ask: Maybe health plans don’t lower costs but do health plans not limit costs? Do health plans not provide any 3rd party oversight of providers who might otherwise have their financial way with a patient? One of the commenters on Dave’s post (Richard R.) makes a good point about this particular question of Dave’s. It’d be good if Dave could provide me with any links to his claim about MLR’s of 25-33% - even 40% as claimed here; at least MLR’s of the behemoth health plans?


On This We Agree
I do agree with Dave that many services provided by health plans might could be commoditized by algorithms. I’m not sure that percentage is 50% but I do hope that other tangible and intangible services of value that can't reasonably be ‘algorithm-zed’ are somehow made more ‘scalable.’ 

Dave raises the value of healthcare pricing transparency. I wonder out loud which members of the healthcare constituency – patients, providers, employers and health plans/sponsors - are the ones who are promoting price transparency? I suspect very few provider organizations are doing this and the ones that are promoting price and quality transparency mostly fall within primary care and certain ‘well-bounded’ medical specialties largely insulated from fluctuations in work effort, practice expense and malpractice expense. Indeed: once ‘healthcare consumers’ have transparency into what is actually happening, it proves to be eye-opening.

Everyone Needs to Sharpen Their Aim
To be sure, ‘achievement of the ‘Quadruple Aim’ should be a target everyone involved with healthcare should aim and shoot for. Just don’t shoot the wrong target because it’s the easiest, most politically correct target. Dave responded with a ‘No’ and a “Resounding No’ to each of his four questions. To me, those questions warrant additional consideration beyond his simplistic responses.

We're All in This Together
One last comment: I too think (and hope and pray) that Millennials will help ‘clean up the mess in healthcare’ that Dave believes Boomers have created. My wife and me have made a fairly significant contribution to the Millennial population Dave has called out: two girls and two boys. Now get out and clean up that mess your Mom and Dad made kiddos!

Friday, February 26, 2016

Over 125 Ideas, Tips & Practices for Before, During & After the 2016 HIMSS Conference

Here's a list of every idea, tip, how-to and other consideration regarding preparing for and attending conference events like the 2016 HIMSS Conference. While I'm unable to acknowledge who came up with each of these items, many were provided by fellow health information technology people and social media ambassadors.

Before the Conference
Category
Hack
Packing
Assign every outfit to a day you’ll wear it, then remove at least 2 outfits. Also cut down on shoes!
Packing
Bring some medicine for headaches, stomach aches, cramps, etc.
Packing
Consider some Doctor Scholl's shoe inserts. They can really help your feet last longer during long conference days.
Packing
Foot roller massage, healthy snacks, oat meal packets and soup packets to use w/ room coffee maker in the morning.
Packing
Foot spray, sore muscle cream, and heavy duty lotion help protect your feet from the floor and your skin from the dry air!
Packing
If you’re worried about what you can’t see in your hotel room, bring disinfecting spray to remove germs + air spray to make it smell pretty.
Packing
Pack an extra charger/battery for your phone! Don't want to run out while traveling...
Packing
Pack Clorox wipes for the oft-touch objects in the room.
Packing
Pack snacks & tea, chargers, dollar bills for tipping, & backups of any materials/files I'll need access to at the show.
Packing
Pick a color palette for the trip... makes it more efficient + provides mix-mix - and - match options on the fly.
Packing
Print a packing list for each trip and check things off as you pack.
Packing
Roll your clothes...you can fit more in you bag and will eliminate creasing. Also pack a travel iron!
Packing
When you get to hotel , unpack & iron everything immediately - unplug the alarm clock, make sure you have lots of water and charge your phone
Packing
Wrap each shoe in a plastic grocery bag so you can squeeze them into the corners of your suitcase.
Physical Aspects
Make sure to have healthy food in the freezer and house clean for your return.
Physical Aspects
Make sure to pack snacks, mints, reading materials...and compartmentalize your packing.
Physical Aspects
Other than charging all your batteries, pack a tasty lunch/snack for the plane
Planning
Attend as many events, including your local chapter’s event, as possible. Don’t be shy and introduce yourself to someone who is standing alone.
Planning
Before the event, try to spend as much time as possible with family and significant others.
Planning
Check at the front desk for spare chargers, people leave them in the room all the time.
Planning
Create a clothing calendar for that trip to help minimize shoes/attire but maximize usage w/o obvious overlap.
Planning
Create To-Do lists for week before leaving office; the last day in office and indexed packing lists.
Planning
Don’t forget about LinkedIn. It’s a great social channel for sharing updates like special events, contests or even just telling people where to find you at the show.
Planning
Have a “rally point”. Meeting someone? Identify a location that’s easy to find,
Planning
Locate a nearby CVS or Walgreens, because you’ll always forget something
Planning
Make sure you’ve got everyone’s number. Phone calls and texting will
Planning
Making sure all your devices are fully charged, that you’ve figured out the shortest route between the airport, hotel and the venue.
Planning
Map out the nearest Starbucks, pharmacy and 24-hour place to get any type of food.
Planning
Promote teaser blogs or videos before your demos on all social channels. 
Planning
Take business cards and the sales collateral and other material you collect each day, and take a few moments back at your hotel (before you start the evening), to make a few notes about who you met, any follow-up you might want to do, etc. Don’t count on just “remembering” everything.
Planning
With a show as large as HIMSS, it is important to keep in mind that the person sitting next to you on the plane, in a coffee shop, or at the gym could be a prospect, so maintain a friendly demeanor and professionalism at all times.
Pre-planning & Travel
Announce that your company will be there. You can even start a countdown to the conference to build the excitement. 
Pre-planning & Travel
Bring a sweater or jacket to every session. So many of those big conference rooms are FREEZING. Recommend layers. You can take one off and put it in your backpack or bag.
Pre-planning & Travel
Consider investing in a nice looking backpack or messenger bag. You’ll need it for chargers, snacks, water bottles, jackets, etc. And all those conference materials and vendor handouts.
Pre-planning & Travel
Don’t be fooled by maps. Get clear directions to where you are going. This applies to buildings and vendor booths.
Pre-planning & Travel
Don’t forget space for the freebies. Only pack your bag half fill with clothes to make room for them. And be choosy about what you take. If there’ something really good, take as many as they’ll let you get away with.
Pre-planning & Travel
Maximize conference benefits: pick up new skills, learn about trends in your field, and make networking contacts
Pre-planning & Travel
Plan ahead for quick trips to charge your phone/device charge and get a snack.
Pre-planning & Travel
Set aside a “vendor block”. HIMSS conferences have LOTS of vendors which means lots to discover as well as specific vendors you'll want to see. Pick a 2+ hour block out of your schedule to do nothing but walk the vendor hall. And make sure you have some downtime after that block too. This is easier than trying to sneak in vendor visits between sessions.
Pre-planning & Travel
Start following the keynote speakers and listening to what they have to say about the conference.
Pre-planning & Travel
Start following the press that will be attending and start commenting on their work – when appropriate.
Pre-planning & Travel
Wear comfortable shoes and dress in comfortable, wear nice-looking clothes!

During the Conference
Category
Hack
At the Show
Pin the posts that are the most important during the show. For example, booth number or where to find you after the show.
At the Show
Use Twitter as home base for unique freebie contests. For example, 10th person to RT this tweet gets a free umbrella. Tip: Make sure to use a hashtag specific to your contest and brand for maximum visibility. 
Conference Sessions
always be your best bet when the going gets rough!
Conference Sessions
Consider occasionally splitting your sessions. If the first speaker of one session is interesting, and the third speaker of another, get up and go to the other session. Make sure you sit at the back of the room so you can leave unobtrusively between sessions. Do not do this all the time, because you want to end the session in a room with people you want to talk with.
Conference Sessions
Don’t be afraid to leave a bad session. If it is clear that a session is not what you thought it would be, leave. Go to one of your second choice sessions and do not spend 30-60 minutes sitting in an unproductive session.
Conference Sessions
Don’t tweet about how bad a session is; but if the speaker doesn’t show or something similarly disastrous happens, alert others to that so they do not waste their time walking down there.
Conference Sessions
Find booth numbers and plan your route (it’s a big floor).
Conference Sessions
Focus. Is there something specific you’re hoping to see on the vendor floor?
Conference Sessions
Go to a session that has a subject you know little or nothing about; you just might learn something and find a new passion.
Conference Sessions
Pick out alternative sessions to attend if your first choice doesn’t work out, and plan your route to get there quickly. Sometimes the room is full. Sometimes presenters don’t show. Sometimes the session just plain sucks and is nothing like the description. So have backup plan.
Conference Sessions
Skip the Keynote!
Unless you have a good way to pass the time, skip the keynote. You’ll spend more time waiting around than listening to the keynote. You can listen to the keynote online later on. Or catch the highlights on Twitter.
Conference Sessions
When you’re in an awesome session, tweet about it. People stuck in bad sessions will see your tweet and can move to your room to see a great speaker they would have otherwise missed.
Conference Sessions
You can attend an event with a drink in hand, but you don't have to keep refreshing it!
Networking
Always remember the first law of socializing: act like a host. This means taking the initiative and introducing yourself to others. Be sure to remember the people you do know and that you’ve met before – including those in your online social circles.
Networking
Be as “socially generous” as possible. It almost never "costs" anything to invite someone along, bring them into a conversation, introduce them to a colleague, connect them to someone of common interests, etc.. People always remember these kinds of things and what goes around comes around
Networking
Be nice and introduce others to other folks you know.
Networking
Buddy Up with a “Wing-Person”
Hunters and gatherers often roam in packs to maximize opportunity; and they join and leave groups as specific needs evolve. Be a hunter or a gatherer at the conference: consider hooking up – for 10 minutes or 2 hours - with one or more people you meet as you roam the conference.
Networking
Consider making a list of all those you want to keep an eye out for. It’s easy to forget while being overwhelmed with all that’s going on.
Networking
Consider reaching out to those you know you want to meet in advance. Ask them about a recent publication or their interest in your area of expertise. Sometimes they'll ask to meet you at the conference
Networking
Deal with Lines When You Must
You can’t get away from lines. So you may as well embrace them. Chat it up with those around you. Consider this: Out of the hundreds of sessions at this conference, you and your “line-mates” have chosen what’s at the end of this particular conference line you’re waiting in. There’s your ice-breaker.
Networking
Don’t be afraid to approach strangers.
Networking
Don't forget your business cards. And bring waaaaay more than u think u need!
Networking
Give More Than You Take
When meeting new people, listen to understand and not just to respond. Ask questions to help yourself remember your new contact. It’s not enough to just learn how someone can help you out but also how you can help them.
Networking
Have a System for Organizing New Contacts
As you walk the booths, wander the conference center and attend sessions you’ll be collecting a lot of business cards. Develop a system so you know which contacts you want to follow up with. Consider sending off a quick email or text to potentially high value contacts at the end of the day.
Networking
Keep in mind that schmoozing is important and okay. Check out other people's nametags so you know who they're. Be sure to wear your nametag in a prominent spot so others can identify you.
Networking
Look for semi-professional social gatherings like user group meetings, meetups, sub-discipline meetings, etc. There are many unofficial and official tweetups in various public areas and restaurants near the conference and they're a good way to force yourself out of room service and into meeting more people
Networking
Make a point of asking everyone (in elevators, crossing the street between hotels, waiting in lobbies, airport shuttles, etc.), “Are you here for the HIMSS conference?"

Most likely they will be and it's fascinating to learn why they're attending. Perhaps you have something in common and it'll be a face to smile at if you meet later on in the conference. Even if they're not affiliated with the conference, you'll probably have a chance to explain why you're in town and it will make it that much easier when you do talk to someone at the conference.
Networking
Make time to socialize outside your pack. If there’s a luncheon, let them know you are going to sit with others to spread your wonderfulness.
Networking
Network to Expand Your Mind
Make an effort to meet people outside of your own circle. By putting yourself in unknown spaces with unfamiliar people you’ll enjoy a different perspective and expand your thinking.
Networking
Never pass up an opportunity to go out with a group to eat or have a drink.
Networking
Prepare a question ahead for someone important that you know will be at the conference. Most people encourage questions related to their presentations--even a couple of days later in the hall.
Networking
Reach Out to Speakers and Presenters
Make even the smallest effort to connect with the speakers and presenters. If you arrive early and see someone milling around at the front of a room, it’s probably a speaker or support person. Go ahead and introduce yourself. During the session, tweet a question or comment at the presenter. Thank them afterwards.
Networking
Recognize and celebrate the fact that the most important and enjoyable part of the annual meeting is the stuff that occurs OUTSIDE of the sessions
Networking
Remember that it's OK to engage people in serious conversations about what they do, what they think about, etc.
Networking
Talk to the celebrities of your profession. Those hot shot people who do keynotes, lightning talks, etc? They’re normal people too. And most of them are very excited about what they do and want to share with others, so they can give you some great conference advice.
Networking
Want an easy excuse to talk to industry celebrities? Do a photo safari. Set a goal to collect as many pictures as you can of yourself with those industry celebrities. Feel free to even tell them that you are doing a photo safari, it makes a good ice-breaker. It will also help you plan out how to meet these people.
Networking
When you meet someone new, even if your interests are a far apart, you can always say "Have you met so and so? You should. I'll introduce you when I see you together." And then, when you do, they'll possibly be grateful for the intro, and they’ll definitely remember your service.
Networking
While listening to presenters, try to look wise--frown, nod, take notes. :)
Physical Aspects
Comfortable Shoes
Conferences are usually synonymous with huge hotels or convention halls. You may have to walk close to a mile just to get to the location. Then there are the 1000’s and 1000’s of step around the exhibit floor and to/from the sessions. Comfortable shoes are a must, otherwise your feet will be crying by the end of the day. If you have to wear heels, slip some flats or flip-flops in your bag for the commute.
Physical Aspects
Dress for success. Dress smart. Look Mahvelous too!
Does anyone really need to be told how to dress for a HIMSS conference? Who’d be so presumptuous to suggest how someone should dress? Billy Crystal summed it up pretty good with his: “It’s always better to look good than to feel good,” you may want to just worry about how you look from the ankles up.
Physical Aspects
Keep Your Heart Warm  and Your Feet Cool
Conference halls are always either freezing cold or boiling hot, never much in the middle. Thus, wearing layers are probably the best way to stay comfortable. Make sure your underlayer is appropriate in case you have to lose your sweater. Ladies – and guys very comfortable with their masculinity - can keep a pashmina in their bag in case a room is cold.
Physical Aspects
Know Your Limits
Most who’ve gone before will agree: one day at HIMSS is much more physically intense than an average day at your regular job. Getting the most benefit from the conference dictates that you treat it as a marathon not a sprint. Be sure not to ruin the next day by cramming too much into the day before.
Physical Aspects
Make sure to eat breakfast and carry some protein bars or energy bars on/near your person.
Physical Aspects
Pace themselves in ALL ways - especially the opening reception – avoid too much alcohol
Physical Aspects
Plan for Feeling Lousy
No one ever expects to feel under the weather but it may happen. Make sure you have a few medicinal items handy so you can avoid wasting time trying to find them and hasten your return to feeling better. Some ibuprofen and antacid like Tums can work miracles on a headache, minor aches and pains from walking and/or that side dish you should have left on the side. Some swear by Emergen-C to get them through that post lunch slump. Consider bringing a supply of those few medicines we all know work for us.
Physical Aspects
Sleep, easy on the alcohol, coffee, lots of water, redbull repeat
Physical Aspects
Snacks and Water
Plan ahead and bring a few good snacks with you. If you have the capacity, consider bringing a couple bottles of water with you. You’ll have it when you want it and save time and money too. Lines will be long – especially around the noon hour – so consider eating “off cycle” which should be easier if your from a different time zone. Keep snacks like nuts, a protein bar, and maybe even a few candy bars to slap that 2:30 feeling with when it comes along.
Physical Aspects
Take the time to eat meals as close to your regular at-home schedule as possible
Physical Aspects
Treat the day as "business" not a "party."
Planning
There’s No Place Like Home
Establish a home base at the conference center to which you can retreat at any given time. A centralized spot or a random seating area off on the perimeter can be a much-needed refuge from the madness.
Post-show followup
Make that connection on LinkedIn with a personalized note or unique follow-up. Follow the same people on Twitter and like their Facebook pages.
Post-show followup
Now that you and your PR company have scored some excellent coverage, it’s time to share it on your social media channels.
Post-show followup
Now that you’ve had a week of non-stop learning you can pull all of that information together. Tip: Instead of writing a round-up blog, try a unique SlideShare summary that you can share on your social channels.
Post-show followup
Pull together a quick 1-minute video of the highlights from the conference and showcase it on your social channels.
Pre-planning & Travel
Emergen C, probiotics, fiber drinks, cough crops, cold medicine. Pack stays in the suitcase always.
Scheduling
Be Open to Serendipity
Since you’ve left a little time in your schedule, walk around the conference center. Hang around the entrance to meeting rooms and exhibit halls. There's a lot going on in the hallways, lobbies, meeting areas and eating areas. Underestimating the occurrence and power of serendipity can be a mistake
Scheduling
Leave Some Wiggle Room in Your Schedule
It’s common for most people to make a conference schedule that lists all the presentations, sessions and vendor booths you want to attend. But adhering to a rigid schedule may not be the best option. So don't overschedule yourself with meetings and parties. Meetings shouldn’t last more than 10 to 30 minutes. Up to half of you time should be unscheduled. You’ll likely get more out of the conference by deviating from your original plan a bit.
Social Media
Follow the conference back channel on Twitter where you can found out about neat things on and off the agenda. Sometimes there is a Tweet Up before the conference, a gathering where people can put faces to handles for conference twitter users.
Social Media
Tweet. If you don’t use Twitter, start learning, because a conference is one of the most useful professional situations for twitter.
Social Media
Use Twitter socially. You can find out about networking opportunities and where people are going for dinner or early evening drinks. This is especially a great tool for the introverted, as you can gather good information and focus your social time to be as effective as possible before you start to tire out.
Warning…Warning!
When you hear yourself say the words "I'll just have one more" stop and say "never mind, I'll take the check"

At The End of Each Day
Category
Hack
Planning
End each working day by reviewing your notes, the panels you attended, the people you talked to, etc and jotting down action items or ideas to bring back to the office.
Planning
Reviewing your notes at the end of the day nets better results than doing it at the end of the conference. Once you’re back in the office, it’s too late — the pressing matters of the delayed work waiting for you will be overwhelming.
Warning…Warning!
A late night in the bar will trash you for the whole of the following day.
Warning…Warning!
Don’t make non-work plans for the evenings.
Warning…Warning!
Don’t use a professional event as your opportunity for social justice warrioring or politicking or proselytizing.
Warning…Warning!
Take It Easy On the Booze
It really is a small world. And cameras and videos are running everywhere. Don’t accidentally embarrass yourself to the point where you have to apologize to others.
Warning…Warning!
Think twice about going to the hotel bar after 9pm to talk further with conference people. This is generally when the hooking-up-at-conferences stuff starts getting kicked off

After the Conference
Category
Hack
At the Show
Sharing is caring. Make sure that you are commenting and re-tweeting and sharing posts while you are at the show.
Decompression techniques
Consider telling people that you’re coming a day or two AFTER your actual return date. So you can have some time to relax and get back in the groove.
Decompression techniques
Set an “out of the office” message the 1st day back home. Use that day to sleep, decompress, unpack, and give your brain a break.
Post-show followup
Follow up on Linkedin, Twitter, and email. Send something clever, make appointments with new leads.
Post-show followup
Follow up with those you promised to follow up with. The sooner you do that, the more respect you gain from your contact.
Post-show followup
People love seeing pictures of themselves.
Post-show followup
Share stories + pics. Follow up on conversations. Write thank u notes.  You can always send it to their company addresses & those are always online
Post-show followup
Write a blog post, share media from the show, and send thank you notes to friends and partners

For more ideas and for staying on top of what's going on at the 2016 HIMSS Conference, be sure to follow @ShimCode and the other 2016 HIMSS Social Media Ambassadors.