Thursday, March 17, 2011

#WHCHPI - Cost and Quality - were can innovation take us

More real time notes from the Health Plan Innovation Conference (Orlando, FL)

KEYNOTE PANEL DISCUSSION: Cost and Quality – Where Can Innovation Take Us?
The goal of innovation in health care boils down to cost and quality. While managing the daily challenges of implementing and complying with reform mandates – in what areas of business is there opportunity? What types of innovation will improve quality and lower costs? How can our leaders ensure lasting innovation and sound solutions?
  • Identify key trends impacting commercial markets and the public sector
  • Innovations in response to key trends:
    • business innovation
    • quality innovation
    • cost innovation
  • Opportunity on the horizon – Re-Engineering for 2014 and beyond
Mohit M. Ghose
Vice President, Public Affairs
Aetna Inc. 

 View Biography

Kathryn Anya Kirvan, RN, MS
Vice President, Innovation, Innovation Resource Group
UnitedHealth Care 

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M. James (Jim) Dougherty
Executive Director, Healthcare Practice
J.D. Power and Associates 

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Martin Graf
Vice President
L.E.K. Consulting 

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Karen Kocher
Chief Learning Officer

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Roy Schoenberg, MD, MPH
President and Chief Executive Officer
American Well Systems 

 View Biography

Everyone will have to prove value of their line item in the Health Care Cost matrix.

Jim Dougherty:
J. D. Power & Associates launched their annual survey results today.

Health Plan Satisfaction declined - AGAIN. Pharmacy and Hospitals have strong results.

"Am I a loyal customer of my Health Plan - No I am a hostage of a decision made by my HR Department."

High Cost is a dis-satisfier. Change is a dis-satisfier.

Very little differentiation across For-Profit Health Plan brands.

48% of people believe that the way they buy health care will change by 2014 and will cost more.
Surprise is the enemy (good or bad).

Roy Schoenberg - American Well:

30,000 Provider gap on the national grid.

It is not about connecting two points (physicians) it is about connecting any two points in the Health Care Team - INCLUDING the Patient.

Online Care - brings care to the patient,not patients to the care.

Interesting example of Delta Airlines. Air crew always traveling and in the air during the day. So online care is available to them at night from anywhere.

[Ed: Thinking back to Ignite #7 Baltimore and the presentation by @Robot_MD about robotics in medicine.] 

President Obama State of Union 2011: "Its about a patient who can have a face-to-face video chat with her doctor"

Anya Kirvan:
Talking about UnitedHealth Personal Rewards pilot program.

An engagement strategy.

People who are pre-diabetic walk around with the condition for around 7 years before being diagnosed.

50% of a person's health status is a result of behavior - Source:CDC

Consumers don't make the optimal choice 41% of the time.

Population Analysis -> Individual Health Actions -> Rewards for Completion

Reward was premium buy-down.

Personalized approach, Personal Scorecard. improves results.

Karen Kocher:

Chief Learning Officer at Cigna. 

Goal is a change of behavior.
Your network influences your behavior.

Your Physician is not as impactful as your network.

We need to influence our networks to be healthy.


what are implications for use of Social Networks?

Cigna is looking at it but is not there yet.
Age 40 is the tipping point. That is where we discontinue having healthy touch points. At that point you have to make an effort.

JD Power: does tribe analysis. semantic analysis enables age, gender analysis.

United: Social networking occurs on its own. e.g. Diabetics - all went to web for information - for recipes.

JD Power: 75% of customer Service Transactions are with a Service Rep by Phone. Information and Communication is low performing yet we have a complex product. Expensive product and too complex to understand.

Understanding is a big issue. 

What Efficiencies are there in Online Care?
- different organizations look for different efficiencies. (Pharmacy different to government and different to payers)
- Many look for first mover advantage
- Other look for better access and coverage
- Clinical efficiency (initial access to acute care. Now seeing growth  in use between Patient and their Doctor - effectively a house call)

Martin Graff: Health Care is behind Reward Programs have been around for a while. eg. Southwest Airlines Rewards started in 1987.

Karen Kocher: You won't change behavior if your network discredits the information from your doctor.

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