Monday, November 14, 2016

Select Tweets from Keynote Address at Texas Association of Healthplans Conference

Today the Texas Association of Health Plans (TAHP) kicked off their 2016 TAHP Managed Care Conference & Trade Show in Dallas, TX. The TAHP is a trade association representing all major commercial & Medicaid health plans in Texas that is committed to increasing access to affordable, quality care for all Texans.
The keynote address was by Aaron Carroll, MD, of The Incidental Economist and the title of his keynote was The Affordable Care Act: Preparing for 2017 and Beyond.

As is more often the rule versus the exception nowadays, the conference is being live tweeted using the conference-specific hashtag #TAHP2016.

The following are highlighted tweets from Dr. Carrolls keynote – courtesy of the @txhealthplans Twitter account.

What Did Dr. Carroll Have to Say about Preparing for 2017 and Beyond?

The three legged stool of PPACA: 1. Regulations 2. Individual Mandates 3. Subsidies

It's difficult for people in the U.S. to get the care they need when they need it.

1/3 of American citizens avoid care because of cost.

The fiscal outlook for #healthcare spending looks better because things have been growing more slowly.

The problem isn't that we spend more on healthcare, it's that we spend more than you'd expect given our wealth.

We have far fewer doctors than you'd expect, a major shortage of generalists.

We are in the lower half of countries when it comes to deaths from cancer.

More people die from heart disease in this country than you'd expect.

Access is bad (but maybe improving?), quality is below what we want, costs are sky-high.

With last week's election, all bets are off. #ACA #Election2016

There's no way the #ACA will stand as it is.

The only thing standing in the way of full-on repeal of the #ACA is a filibuster.

Most laws require half the house and half the senate.

Option 1 for the #GOP - Reconciliation, only requires 51 votes. #ACA

Option 2 - Repeal & Replace #ACA. Option 1 leads to 22M people becoming uninsured; won't be popular.

Paul Ryan's Better Way is a refundable tax credit to help defray the cost of premiums.

Paul Ryan's plan does keep guaranteed issue but does not keep the community ratings.

There are too many doctors that are sued on cases that don't have any merit. #tortreform

In 2003, Texas passed comprehensive tort reform.

Just passing tort reform doesn't bring it down.

Tort reform is necessary, malpractice reform is necessary; but it's a red herring.

Medicaid block payments are the low-hanging fruit of the next few years.

Right now, Medicaid works by matched money.

The debate is how much money are they going to give and how much will dry up in the future.

Most savings in budget are from radically reducing payments; cut spending by 35% by 2022 & 49% by 2030.

The devil is in how this will be spun politically and how payments will be reduced in the future.

Life expectancy isn't that different at age 65 since 1970.

The poor 1/2 of U.S. has seen their life expectency increase by a year. Hasn't gone up as much as people think.

How much will it cost? Employers would have to pay additional $4.5B. The costs outweigh the savings.

Other ideas - change the actuarial values of plans offered (60/70/80/90 ➡️ 45/55/70/85)

The #ACA isn't as prescriptive as people think. Birth Control is an example.

The #ACA doesn't demand birth control be covered. It delegates that decision to the HHS Secretary.

Inaction is as good as action. Right now, the Obama Administration is fighting King v. Burwell. 

There's a lot we could still do to improve the #healthcare system. #txlege

Anyone who tells you they know what's going on right now is lying. #ACA

What's Next?

The TAHP conference runs through Wednesday, November 16th. You can know more about what's been said and shared at the conference by following the #TAHP2016 hashtag.  You can also learn more about healthcare data, technology and services topics by following me on Twitter.

Tuesday, November 8, 2016

22 Notable Tweets from Day Two of the 2016 Healthcare Internet Conference

Billed as “Healthcare’s Most Forward-Thinking Conference on Marketing and Internet Technology,” the 2016 Healthcare Internet Conference held November 7-9 at at The Cosmopolitan of Las Vegas appears to be a popular event for healthcare marketing and communications professionals – and wanna-be’s.

I say this because the #HCIC16 hashtag was all over my Twitter stream today. I recognized a number of the people and companies tweeting and pulled out 22 tweets that stood out in the first couple hours to Day 2. Here they are:

Good reminder on content layout and page structure to deliver what's important immediately to the user!
Always quotable @bladelink "only difference between a vision and a hallucination is how many people can see it"
Do you remember the first time you logged onto the internet? - Mine was good old 
Motivation for being online is 'What are we looking for?" Email once exciting. Not anymore!
We have to stop reacting and start planning.  #manbun
Do you have a @Myspace page? What are you, a freak show? LOL'ing in the morning with  @unmarketing and his beautiful #MANBUN at #HCIC16
51 million people daily still use Myspace. What?!
Grasping at all new social media isn't real time marketing, it's reactive marketing, and there is no strategy.
On chasing social trends, "It's not real marketing, it's reactive marketing" - Scott Stratten
#HCIC16 Context of the platform matters as much as context of the message. Yes! 
The millennials are coming, The millennials are coming!
When we say millennials we don't even know what we mean. We just fear youth.
Millennials have something we don't have. Hope!
Dear millennials: pencil joke refers to how we had to manually rewind cassettes. You're welcome. :)
We forget that we are in healthcare, an industry that changes lives daily.
We are in an industry that affects lives. Most others have to find motivation elsewhere.
But for real: good take on generations, how to reach them and planning vs. being reactive from
We get very territorial about how we communicate. Should be finding out who our audiences are & be there with an open ear.
The only communication that matters is the one that is for the customer that needs it.
It shouldn't be "this is how you reach us," rather, "how do you want to be reached?" Only the patients' preferred channel matters.

19 quotes and paraphrased interpretations of comments made by Scott Stratten of @unmarketing

The following were culled from tweets shared during Scott's session titled: Everything Has Changed and Nothing is Different.

“If we can't trust the exosystem of the Internet, then the system doesn't work. @unmarketing on paid fake reviews at #HCIC16”

“Integrity is not a renewable resource. You don't get it back quarterly.”

“It's not about what the hospital wants; it's about what consumers want. Need to focus on how pts want to communicate.”

“Match the communication preference of the customer, not your communication preference”
“Negative reviews are solved simply by one thing. Response. People want validation that they were heard”

“Not every metric is a good metric. It's our job to avoid vanity metrics. They sound good but amount to nothing.” 

“We are creating a stereotype with millennials and it's not fair.”

"Can we stop stealing stuff and sharing it in hopes it goes viral for a vanity metric that doesn't matter" 

"I saw a blog post that says millennials don't like meetings." @unmarketing "What? Nobody likes meetings!" 

"The worst kind of patient complaint is the one you don't hear."  Participate and respond. 

 “Video can actually hurt your brand - due to the unforgiving nature of video, not to mention live video.” 

“What are we trying to say and does it make sense to say it through this medium? Content context matters. “ 

"You guys are lucky. You are in an organization that changes lives." Not everyone has that.”

“We are in an industry that affects lives. Most others have to find motivation elsewhere. “

“The worst kind of patient complaint is the one you cannot hear. Your brand becomes unanswered complaints” 

“We trust strangers' reviews before an organization's. Ethics matters. “ 

“Your brand is whatever words come out of a person’s mouth“

“If we're not going to do it very well, then why are we doing it? @unmarketing on live video, 360 cameras, VR and AR”

“If you're in patient care, then care. @unmarketing #nof1”

That's All Folks!

For more information, insight, opinions, intelligence, and ramblings about healthcare data, technologies and services, consider following me on Twitter when I share as @ShimCode.

Friday, November 4, 2016

Top 5 Blog Posts for August, September & October of 2016

The following five blog posts of the 25 posts I've written over the last three months are the most popular - with each receiving between 1000 and 1200 hits as of today: November 4th, 2016.

Healthcare Executives Rank Top 10 Issues Facing Health Plans & Providers 08/03/16

Wednesday, November 2, 2016

Population Health, Community Health & Who’s Going to Make Transformative Changes?

GuideWell Insights Lounge - Oliver Innovation Conference
Here's another 'transcripted synopsis' of an interview by Kate Warnock, GuideWell Social Media Manager and Healthcare Inquisitor Extraordinaire, from the GuideWell Insights Lounge at the 2016 Oliver Wyman Health Innovation Summit.

The following are questions from Kate's interviews with Josh Michelsen, Health & Life Science Practices partner at Oliver Wyman and Director of the #OWHIC Leaders Alliance for Oliver Wyman.

Kate quizzes Josh talk about population health, its differences from 'community health,' and how Josh believes a group effort targeted at a 'community microcosm' might effectively improve the population health of that defined population.

Here We Go!

Kate: How would you describe population health and how is it different from Community Health?

Josh: That’s a good question. You know it’s certainly a buzz word - both are buzz words in the industry.

And they’re linked but I do draw a little bit of a distinction between the two. So when I think of population health, at least as the industry thinks about population help, it’s four pieces:

Four Parts of Population Health

First Piece: it’s about actually improving the Triple Aim; so quality, cost and the experience.

Second Piece: It’s for a defined population. So you are trying to improve those pieces for a specific population. It could be quite micro; so it could be around Medicaid or Medicare, commercial or could be all-encompassing.

I think population health also has a Third Piece which is much more of a holistic approach to health care: you’re not just receiving the patient but you're proactively trying to improve their health.

And the Fourth Piece is that whatever organization is responsible for that population, they’re actively at risk for it - financially at risk.

So that's kind of how I think about population health, at least from an industry standpoint.  And so community health is similar but I think it’s a little bit different in that it’s the foundation on which people are trying to improve the health of a specific population.

Community Health

Josh: So in a community, it’s about all the social determinants of that community. It’s about economic vitality. It’s about some of the structural impediments and it’s about social impediments. And so, while I think in a given community, take Chicago. In a pocket of Chicago, if you were trying to improve the community health and really lay the foundation for that, you might take a specific cell population and laser in. And have a provider or payer organization responsible for the cost quality and experience (of that specific cell population.)

But I think the community health is a much broader and more public health oriented ambition.

Kate: Is it fair to say this 'community health cell' is more location-based? Is it more about a geographic region versus population health? which doesn’t necessarily have the same quarters? (Clarify at 3:02)

Josh: Yeah, you know, that's probably a fair way to think about it. Most organizations here [At OWHIC] and we were studying a little bit of what’s in the mission. So we've looked at the mission statement of payers and providers and health IT organizations. And what we found was that organizations that had roots in a specific community, or a specific market, tended to gravitate to words like 'improve the health of their community and the individuals that they serve.' Versus those [organizations] that are location independent; those that are more location independent didn’t quite draw that same connection.

So I do think being able to put your arms around a geography or micro geography is certainly an important attribute.

Kate: Ok. Alright. Fair enough. Next question for you Josh:

Who are the constituents required to drive better health for a community?  Who's really going to make a transformative change we all want to see?

Josh: Well, we have many organizations here that happen to be some of the largest employers in their market. So whether it’s hospitals or payers, they tend to be in the top, you know, two or three organizations in terms of employing individuals. So they’re naturally an anchor and then there’s this notion of an anchor in the community that you can rally around. But I think it’s a lot broader than that.

First Steps - Per Josh

So some of the first steps in transforming the health of the community are connecting the organizations that are responsible for care. It’s not just the hospitals and it’s not just the physicians. It’s the safety nets. It’s the FQHCs. It’s social services. And you start to orient around that anchor.

Next Steps  - Per Josh

Then you broaden it. You start to say: “Well, who else is there?” It’s the retailers that have a role. It’s education that has a role. It’s the churches that have a role. And religious affiliations. And what we've observed is that some organizations are you really saying: “What could we do to connect the care and other communities?" 

And other organizations are starting to say: “Wait a second. If we’re thinking about social determinants, who plays a role in these social determinants?"

Community Health Improvement Initiatives

And then the third layer is many Community Health Improvement Initiatives (CHII) really start with organizations that have a physical presence. And what we’re seeing is that there's an opportunity to pull in innovators and technology companies to actually assemble the supply side of these CHII's a little bit differently.

So it’s not just a provider in a market that has a new care model; it’s what would happen if you actually incorporated the provider with consumer tech and engagement around specific populations? And we think there's a lot of promise and actually attracting innovators to test their models and refine their models through Community Health Improvement Initiatives.

Who's Your Anchor?  - Per Josh

So it’s quite broad but we do think it’s important to have an anchor that can serve as a facilitator and really help rally investment and energy across multiple organizations.  

Back to You Kate...

Kate: You know, as you respond Josh, you can' t help but think that, with so many players involved in this, really just speaks to the complexity of managing true health and helping people focus not just on episodic care but on that holistic vision that you painted for us in the beginning. So just one of the challenges, but so many opportunities too, when you have the right people involved.

So one more question Josh.

What new business models or collaborations are you seeing emerge as a result of organizations wanting to make a substantial impact on the health of their communities?

Josh: I guess a couple things. One is, we’re seeing organizations rally around a major cause. So whether it’s something like hunger or employment we’re seeing some healthcare organizations say “You know what? We’re going to find an issue and rally around that issue and be quite systemic about it.” So take hunger as an example. You know the role of a provider could actually be creating, as part of their care pathways, nutrition plans and then tying into what restaurants are doing in the community. And addressing food deserts.

Marble the Solution Set

And so, taking an issue like that and actually marbling a set of solutions around a specific issue. We’re seeing other instances where it’s actually city lead and so the government is going to come in. Chicago is an example of this. They have invested in a healthy community or Healthy Chicago 2.0. They are inciting or are asking multiple constituents in a market to rally around multiple issues.  So it’s a much more diverse set of issues that they’re taking.

Preventive, Proactive Care Engagement

And the third thing which I haven't seen take place but I would love too is and we’re here talking about it is this idea of health and wellness. We have sick care and we have preventive, proactive care engagement. And we think there’s an opportunity for organizations in a market in a specific geography to create a new marketplace: a marketplace for health and wellness. If a community were actually able to, it would build up demand at scale; have employers or multiple employers rally around a new supply side.

So not just by the traditional provider and the traditional network and the traditional plan of benefits, but have a payer or an employer wrap a product around the new supplies. So creative assembly of the supply and have traditional organizations actually integrate their solutions with some of that; innovators that we have in the room and then have a new marketplace around that and have that sit side-by-side with the traditional. And hopefully you’ll build up demand and show that this alternative model is possible. So that's where we’re hoping this goes or at least personally where I hope this goes.

How Long is this Going to Take?

Kate: I gotta ask. So, timeline for something like that is this something a year out or are we looking 3 to 5 years? Because that sounds, I mean it’s a very…love the idea of that kind of model. Realistically how long would it take to really get something like that to begin to build traction?

Josh: Well. So what we've observed in the market is anytime you're trying to bring a new product, even… take a payer that’s moving into Medicare Advantage space and trying to build adoption. You don't go from zero lives to tens of thousands of lives or hundreds of thousands. That can take a while. What we’re hoping is that transparency around the effectiveness of those solutions is something that helps influence it.

Kate: It’s its own best marketing. (Transparency)

Josh: And then, we are seeing examples of smaller communities, maybe not large metropolitan communities, but with smaller communities bring government, public health providers, banking, transportation, all kinds of all sectors together.

And in that smaller microcosm they’ve been able to do it; in part because they control many of the levers. Whereas in a market place like Chicago, it’s a lot harder to do that. So we’re hoping that, at least in pockets, were able to see that kind of new supply rise where it’s many organizations coming together and then buying that in a for package way.

That's All Folks!

Kate: Okay Josh you paint a really, really fascinating look ahead into the future of healthcare and I appreciate you spending your time and your insights with us here at the Guidewell Insights Lounge.

Thank you. My name is Kate Warnock. Thank you so much for watching.