THE 'EDGE REPORT BLOG

Three Key Takeaways from HCEG Annual Forum

THE 'EDGE REPORT BLOG

Three Key Takeaways from HCEG Annual Forum

Last week in Boston, Massachusetts, health plan leaders, providers and solution vendors from across the country gathered to discuss the issues facing the industry today, participate in the Watson Experience and learn the steps IBM is taking to transform healthcare, and have a little fun by taking in a Red Sox versus Yankees game at historic Fenway Park. As a sponsor, HealthEdge led a roundtable discuss about which issues should the industry focus on in 2020 and participated in a panel about value-based reimbursement. Below are three key takeaways from the conference:

Are social determinants of health phase two of value-based reimbursement?

The industry has been marching on the road to value-based reimbursement for over ten years now, and while some programs have found some success, a silver bullet has yet to be defined. We heard from panelists representing health plans, providers and solution vendors (including HealthEdge’s own Vice President of Marketing, Harry Merkin) that social determinants of health (SDOH) may be phase two of value-based reimbursement. But what does that mean when there are no regulations or industry consensus around best practices for SDOH? Part of the answer may lie in analytics and the massive opportunity to connect all the dots. We also heard from the innovators at IBM Watson in Cambridge, Massachusetts, about how Watson’s artificial intelligence provides physicians across the globe with relevant and comparative data (including information about SDOH) to assist with decision-making. So, while value-based reimbursement has enjoyed bi-partisan support (many models were put in place as early as the George W. Bush administration, continued through the Affordable Care Act and are still active today) it’s time to bring social workers to the table to address SDOH and how they affect total consumer health and how they may shake-up value-based agreements between payers and providers.

Digital health can transform healthcare, but regulations are in the way

The digital generations are here: Generation Z was born into it, Millennials were raised on it, and Generation X and Baby Boomers have quickly come up to speed. Now that other industries have largely transformed to cater to the needs to tech-savvy consumers, consumers have turned their eyes to healthcare. But panelists from Change Healthcare, the American Telemedicine Association and Blue Cross Blue Shield Massachusetts agree that regulations are a blocker to digital transformation because technology advances far outpace law makers. With more health plans putting next-generation solutions in place to respond to the demands of their members and operate more efficiently, payers need help from lawmakers to update laws that represent the current and future landscape.

2020 HCEG top 10 challenges and opportunities for 2020

Drumroll please… Conference attendees debated and voted on the top 10 issues, challenges and opportunities that will face the healthcare industry in 2020. This year’s list differed from other years because it put transparency, the consumer, and transformation at the very top. The issues facing healthcare in 2020 are all interconnected and solving one is not possible without addressing the others simultaneously. At the core of many of the top 10 issues is modern, flexible technology that can bring transparency to light and connect the various stakeholders. Technology alone is not the answer, people and process are all equal players, but technology that allows for agility and scalability is essential for most of the top 10.

  1. Costs & Transparency 
  2. Consumer Experience 
  3. Delivery System Transformation
  4. Data & Analytics
  5. Interoperability/Consumer Data Access
  6. Holistic Individual Health
  7. Next Generation Payment Models
  8. Accessible Points of Care 
  9. Healthcare Policy
  10. Privacy/Security

 

Subscribe to The 'Edge Report Blog