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How NOT to Do Population Health

Posted on June 24, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The famous world traveler, Dr. Nick (he’s also CMIO for Nuance Healthcare), is attending #AMDIS15 and was kind enough to share out this awesome image:
How to Not Do Population Health

This slide was shared by Coray Tate from KLAS and is a great message to consider.

I also don’t think we should come down too hard on Humana. As healthcare companies start to stretch the normal, stuff like this is going to happen. I think that’s a good thing. At least the diabetic now had a chocolate bar that they could share with someone like me. Then, they’d have a happy friend and making a friend happy is worth so much more than a chocolate bar.

Working with United Healthcare, Aetna, Humana and Walgreens

Posted on May 31, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I had a unique experience attending the Life At 50+ event that AARP puts on. It turns out that life at 50+ revolves around healthcare and wellness in many ways. Plus, they put together the AARP Live Pitch event for healthcare companies to pitch their companies to a board of judges and then to the AARP members. The later was quite interesting to watch and who doesn’t love hearing from real customers.

After lunch, they also had a panel with executives from United Healthcare, Aetna, Humana and Walgreens to talk about what they look for when it comes to working with healthcare startup companies. There were some predictable things like “we focus on the team” and also some off the cuff remarks like the tweet embedded above about “stuff that actually works.”

One thing was clear that these companies were all in an evolution from their core business to something else. As one panel member said they were moving from a claims processing company to a wellness company. Another panel member said they didn’t see themselves as providing healthcare as much as enabling healthcare.

I was most interested to hear these executives talk about what they looked for in a company. The general consensus seemed to be that they wanted companies that understood their gaps and could fill their gaps. Although, when they were asked to talk about their gaps, the executives seemed to have a hard time describing their gaps. I think this is the core challenge. If they really knew their gaps, they’d be filling it themselves.

With that said, I did pull out a couple areas that seemed of great interest to the panel. Those two areas were medication compliance and getting patients to the right doctor. If you can help with either of those things, then your company would likely be of interest to these companies. Although, as the tweet at the top says, you better make sure it works before you think they’re going to work with you.

I also found it ironic that some on the panel wanted an end to end solution while another described them as looking for point solutions. At the end of the day, I don’t think they’d mind either solution if that solution provided value and had seen some traction. For example, one panelist talked about coordinated care, but they also said they wanted to see proof of the coordinated care in action and implemented in a hospital system.

I guess none of these things are too surprising. Find something where you have traction and provide value and you’ll have lots of opportunities.

Private Payers Need to Join Humana, CMS With EHR Subsidies

Posted on June 30, 2011 I Written By

Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider.

Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers could go out and buy technology. As the country’s largest purchaser of  healthcare services, CMS wanted some value for its money (not exactly something you hear every day when it comes to government spending).

I’d been hearing for years that major commercial health insurers also were willing to share some of the savings from EHR adoption, but not until the largest payer of them all, Medicare, did so first. The private sector usually does follow Medicare’s lead when it comes to major policy shifts. Medicare now has done so, but private payers have been mostly silent. Mostly.

This month, as InformationWeek reports, Humana teamed up with Allscripts Healthcare Solutions to offer physician practices financial incentives for purchasing Allscripts EHR systems. The deal is similar to one Humana cut last year with Athenahealth. A few Blue Cross and Blue Shield plans, notably in Massachusetts and Rhode Island, have led similar programs at the state level, with eClinicalWorks the main partner.

But unless I’m forgetting something, Humana is the only big payer that has jumped into the game. Where are the UnitedHealthcares, Aetnas, Cignas and WellPoints of the world?

Payers, it’s time to make good on the lip service you gave years ago and start passing on some of the savings you will realize from Medicare, Medicaid and hundreds of thousands of providers spending billions of dollars on EHR technology and health information exchange efforts.