HIMSS18 Series: PHS Shares How to Drive Enterprise ROI at the Largest Health IT Conference
Starting on Monday, March 5 more than 40,000 healthcare industry experts will land in Las Vegas for the HIMSS conference, the largest health IT event in the U.S. There are thousands of speaking sessions and showcases to see that will teach you everything from how to build APIs to making sense of genomics.
We’re especially excited to attend and hear our own MedeAnalytics’ customer, Soyal Momin, Vice President of Data and Analytics at Presbyterian Healthcare Services (PHS), present an educational session at the conference. The session titled, Driving Enterprise ROI by Eliminating Data Silos, will take place from 11:30-12:30 p.m. PT on Tuesday, March 6 at the Venetian Convention Center in Palazzo D. Soyal will address how after three years and many resources invested in an enterprise data warehouse, PHS needed an action plan and analytics solution that could turn raw data into business value. Soyal will discuss how PHS adopted a data-driven culture that allowed the health system to save more than $11 million and outline best practices to achieve this level of success, including:
- Creating business value from enterprise wide data and analytics strategy and execution
- Assembling an infrastructure around people, process and technology to drive a data-driven culture
- Discussing stakeholder buy-in and organizational-wide support by leveraging change management tools and creating a culture of inclusion across the enterprise
Can’t make the session? Make sure to download the presentation and review the materials on your own here. We’ll also be at HIMSS so don’t miss out on a chance to chat with us – you can schedule a meeting with us here. To achieve similar success as PHS, check out our enterprise analytics solution: http://medeanalytics.com/solutions/enterprise-analytics.
HIMSS18 Series: The Top Payer Trends to Watch
We’re a little more than one week out from the annual HIMSS conference which begins on Monday, March 5 at the Sands Expo Center in Las Vegas, NV. The event brings together more than 40,000+ health IT professionals from various sectors of the industry. To help you better prepare for this whirlwind event, we connected with our very own Diane Gerdes, payer product marketing manager, to gather her predictions on what trends she believes will be top of mind for the payer industry and some major topics that will be discussed during the conference.
Here are Diane’s four predictions:
1. Increase in merger and acquisitions
The payer market continues to experience drastic change and game-changing mergers and acquisitions (like the CVS and Aetna merger) will continue to transform how the insurance market operates. Combining forces amongst major players will help bring a new perspective to the industry and allows for payers to differentiate themselves and remain competitive in a fast-moving space.
2. Rapid development of health apps and new data
Since the creation of smartphones and wearable technology – consumer-facing apps and data have boomed. In the United States, there are more than 200 million smartphone users with access to more than 4 million apps. In addition, a recent article in Managed Healthcare Executive reports that the wearable market is expected to grow from 101.9 million units sold in 2016 to 213 billion units in 2020. This is an incredibly large, untapped data pool that holds great promise for the healthcare industry – “smart” information that leads to smarter decisions. We can expect payers to employ more consumer-facing applications and devices to better understand and connect with their members across their healthcare journey.
The Association Health Plan Proposal is Making Big Waves – Here Are Our Predictions
Earlier this month, the Department of Labor (DoL) released a proposed rule that allows small business and employee groups to purchase association health plans (AHPs) instead of employee-sponsored or individual health insurance plans. This recent proposal was met with mixed views across the healthcare industry – some believing this would further complicate the insurance market or weaken consumer protections.
Our very own Bruce Carver, associate vice president of payer services at MedeAnalytics, offered his insight on the potential impact this proposal can have on the insurance market. His thoughts on benefits, risk and coverage are below.
What are the primary changes this rule would allow?
The Trump administration has proposed a new rule, based on an executive order by President Trump, that allows Association Health Plans (AHP’s) to expand the types of groups that can form an AHP. The two primary changes in the rule would allow AHP’s to be offered membership without regard to state lines, and allow self-employed individuals to take part in a large-group AHP.
What does this mean for essential benefits?
This proposal could allow insurers to sell plans that do not cover certain essential health benefits, like mental health, substance abuse treatment, maternity care and prescription drugs. This may cause a lot of confusion with members when they are treated by providers and any limitations in coverage will need to be clearly communicated between members and providers, in an already confusing market. Members will also need to consider if the plan benefits them based upon pre-existing conditions.
What about risk?
Any time you increase the number of people covered in a plan, you have the capability to diversify risk. The concept of “pooling” members in a region for covered benefits by putting small groups together into a single larger group is not new. Some states allow for this type of “pooling” under group rating programs for disability and workers’ compensation benefits.
How West Tennessee Healthcare Turned Bad Debt into Reclaimed Revenue
The healthcare reimbursement landscape is continuously changing, creating numerous challenges for healthcare organizations as they look to increase revenue. In fact, the revenue risk among not-for-profit and rural healthcare systems are even greater. The National Rural Hospital Association, estimated that 673 rural facilities were at risk of closure, out of over 2,000. West Tennessee Healthcare (West Tennessee), one of the largest, rural, public, not-for-profit healthcare systems in the U.S, acted proactively to combat this trend. In our recent case study, we examine how West Tennessee leveraged analytics to achieve financial success.
West Tennessee has four hospitals, two medical centers and offers 20 primary and specialty care centers. They service a population of 500,000 and with such a large rural patient base, needed guidance to address the following issues:
- 3:1 bad debt to charity ratio
- High percentage of accounts in arrears
- Long lead (30+ days) to denial and appeal process
Health IT Headlines for 2018
2018 is already off to a strong start with the J.P. Morgan Healthcare Conference and StartUp Health Festival making headlines last week. As 2018 progresses, we want to share the trends that we expect to make headlines this year:
- Mega merger and acquisition activity – 2017 was filled with notable M&A activity including CVS and Aetna, Humana and Kindred and Optum and AMGA, to name a few. We expect to see this activity continue throughout 2018 as payers, providers, pharmacies and more look for ways to innovate, meet consumer demands and ultimately improve the quality and cost of care. Bruce Carver, associate vice president of payer services at MedeAnalytics, shares additional thoughts on recent merger activity in our blog.
- Consumerization of healthcare – With consumer-facing companies outside of the traditional healthcare space making moves to enter the industry (like Amazon, Apple and Google), consumer focus is critical. In 2018, this focus will only increase as consumers continue to demand user-friendly and easy to use platforms and interfaces. With all the competition in the industry, healthcare organizations will have to ensure they are keeping the consumer top of mind to stay ahead.
- Emerging technologies, like AI, will take the stage – In 2017, the adoption of AI technology made headlines across all industries, healthcare included, as organizations looked for innovative ways to leverage this new tool. As we head into 2018, companies like Google will continue to lead the pack by working with startups that are focused on finding ways to leverage this technology to improve care. We recently sat down with our CTO, Tyler Downs, to discuss trends in AI in healthcare and to hear how companies can use AI to power data and analytics.
- Clarity around industry uncertainty and policy changes – With the Trump administration and new faces in prominent health IT positions, the industry saw major shifts in 2017. According to a recent poll, healthcare is the one topic keeping both Democrats and Republicans up at night. 2018 will hopefully bring some clarity to the shifting tide as policies get ironed out and the state of Obamacare is decided. Regardless of these policy changes, providing patients with the best quality care should remain the industry’s top priority.
With all the new trends, emerging innovations, policy changes and more, is your organization prepared? Check out our solutions page to learn how MedeAnalytics can help you find success in the new year or contact us for additional information.