Wednesday, August 3, 2016

Healthcare Executives Rank Top 10 Issues Facing Health Plans & Providers

When it comes to identifying the main issues and concerns facing healthcare providers and health plans, who should you trust the most? The Government (HHS/CMS)? Vendors? Consultants? Industry publications that survey their readers? Firms like Gartner, KLAS, etc? While those are all possible sources, there’s a source I’ve found that I think may be less biased than any of the above: The Health Care Executive Group (HCEG) and their Annual Top 10 Healthcare Issues & Concerns list.

Who’s the HCEG and What’s the Top 10 List?


HCEG is a national network of select healthcare executives and thought leaders who navigate the tactical and strategic issues facing healthcare organizations on a daily basis. Originally founded in 1988 as the Managed Care Executive Group (MCEG), the Health Care Executive Group provides a forum where the open exchange of ideas, opportunities for collaboration, and transformational dialogue freely ensues.

The HCEG's Top 10 list has been a pillar of the HCEG for over 10 years and is compiled directly from HCEG member surveys and discussions held at their Annual Forum. It identifies priorities and challenges facing healthcare payers and providers across the country.

What’s on Top of the List?

The HCEG web site contains the Top 10 Lists for 2011 through 2016 and these lists can be found here. In an attempt to identify common themes and potential outliers on the list, I created a simple frequency distribution using the data found on the HCEG web site. I've included a summary of that analysis at the end of this post.

Note: This is an unscientific analysis based on my interpretation and understanding of the HCEG Top 10. See the table below for specific rankings obtained from the HCEG web site.


Here’s what I found are the top five most common areas of concern for health care payers and providers over the past six years:

1. Payment Reform and Transparency
2. Big Data/Analytics
3. Customer Experience and Consumerism
4. Government Programs, Medicare and Expansion of Medicaid
5. Managing Costs, Inter-operability and Operational Priorities

Items occupying a lower rank on the lists include the following:

1. mHealth, Telemedicine, & Social Media (#1 in '14 but #9 in '15)
2. Personal Monitoring, Wellness, Incentives & Rewards
3. Retail Health Care (#6 in 2016)
4. Staffing (#10 in 2013 and not ranked since then)
5. Innovation/Collaboration (#10 in 2013, not ranked since then)
6. Cybersecurity (Surprisingly #9 in 2016)
7. Pharmacy (#7 in 2016)
8. Genomics (#10 in 2016)

What Else?

The lists identified various health care reform mandates and regulations that the industry has enduredpre-ACA (HIPAA 5010, ICD-10), ACA (MLR, HIX) and post-ACA. As can be expected with transitory mandates/regulations topics, some dropped in rank or dropped off the list entirely after implementation dates passed.

What’s Coming Next?

The Top 10 list for 2017 will be developed during the upcoming HCEG Annual Forum in New York City on September 12-14. Information on attending the HCEG Annual Forum can be found here.

Note: Based on an inquiry I made, I understand that some special ‘upgrades’ and supporting materials may be in store for the 2017 list. If so, I’ll be sure to share if and when that list and information is made available.

Ranking of HCEG Top 10 Categories - 2011 - 2016
Rank
Area
16
15
14
13
12
11
1
Payment Reform
2
1
2
6
3
4
Transparency
5
3
3



2
Population Health/ Care Management/ Analytics
3


4
2

Big Data/Analytics
8
7
8

6
2
3
Consumer Experience
1
6
5



Consumerism

8
6
3

8
4
Medicare/Medicaid Expansion

5
7
5
4
6
5
Administrative Expenses/ Operational Overload

4
10
7
1
5
Provider-Payer Integration
4



7
10
6
Retail Health Care
6





Mobile/Digital Devices/Social

9
1
8


Personal Health Monitoring

10
9



Innovation/ Collaboration



9


Pharmacy
7





Staffing



10


Cybersecurity
9



10

Genomics
10





7
Health Insurance Exchanges



1
9
3
Health Information Exchanges




5
7
ACA Implementation

2
4



Reform, Regulations



2
8
1
Reform Uncertainties





9

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