Wow. AHIP: Institute 2012 was quite a ride. It was informative listening to Malcolm Gladwell and Atul Gawande speak about the pressing challenges in healthcare and hearing their unique perspectives on how to arrive at a solution beneficial to all. Not to mention the sessions with Deepak Chopra, Paul Begala, and Ari Fleischer, which were inspirational and provided yet another perspective on the politics and emotional intelligence driving change within the healthcare ecosystem.
What an energizing, educational, and motivational week it was, thinking outside the box of not only the processes of healthcare that we immerse ourselves into, but also thinking about the larger context of the purpose of healthcare companies including consulting organizations like West Monroe. As one of the speakers said, “we are here to enable health for all,” which is a message I hope we all value and embrace.
As expected, there were some consistent messages that emerged throughout the several days of sessions and breakouts. Below is an outline of what we extracted as the major themes:
- The healthcare ecosystem is very much in flux and SCOTUS rulings, the presidential election, etc. will play a critical role in shaping that ecosystem.
- Big Data is still a big deal. He who has data and the ability to collect and mine big data will reap benefits both financially as well as from a medical outcome basis.
- Capturing the right data is a challenge and payers must work to capture more than claims data.
- Payers should capture consumer data, clinical data (from providers), pharmaceutical data and social data.
- Coordination of care is key, especially between payers and providers. This is critical in containing cost and delivering best outcomes.
- Payers must coordinate better with providers and pharmacists to avoid unnecessary costs. This is particularly important around the dual eligible coverage.
- Coordination is not just along data, it is along processes as well. There is often a delay from the time a patient is contacted by a payer until when that patient receives care. Finding, scheduling a provider and following through are key elements of the process that needs to be coordinated.
- Due to the coordination required, there is a shift towards Integrated Delivery Networks and Systems where a payer and provider are coordinating care together.
- Population Health Management (PHM) & Wellness are top of mind for all payers.
- Not only does coordination of care have to happen to ensure higher quality of treatment for a given patient; payers are also expected to do a better job across a population.
- Providers don’t know how to manage the health of a population (in fairness, neither do payers).
- Payers and providers are expected to partner better with the government on PHM The massive amounts of data that the government has become an advantage for payers and providers to leverage towards better outcomes.
- Wellness is a key demand and it goes well beyond disease management to encompass total well-being including financial, mental, spiritual and social wellness.
- Aging is the desired result and not a problem.
- Life expectancy is much greater, but quality of life is key.
- Consumer engagement is paramount.
- We all know we need to engage consumers in their own health. There are dozens of behavioral models and no model has emerged as a dominant force as of yet.
- Health coaching is becoming a new way to engage patients in health. It’s interesting to note that there is virtually no difference in outcomes between digital coaching (telephonic or computer) and in-person coaching.
- Consumerism is the new model (again) of the future for health plans.
- Learn from financial services and retail industries. Use consumer data to understand their preferences and integrate them seamlessly into the healthcare ecosystem.
- There was no mention of ICD-10; not a single session centered on one of the hottest topics of 2010.
Overall we thought the conference a great success and look forward to payer organizations moving forward and progressing with initiatives aligned with the aforementioned themes. It’s been exciting to help our clients think through these topics as they plan for 2013 and we look forward to collaborating with them in developing and implementing their strategies.
Will Hinde | Munzoor Shaikh