Wednesday
Apr092014

Hacking a Better Health System

By Kim Bellard, April 9, 2014

Who knew hacking might help us reinvent our health care system?

I must be old-fashioned, or at least not a true techie, because I still thought of hacking as a bad thing.I was thus surprised to read in The Wall Street Journal that “hackathons” are a trend for the good in health care. 

For others who are also behind this particular curve, hackathons are intense, all-night (or more) sessions when a small groups of programmers band together to attack tough specific problems with concentrated coding efforts.

The Journal article highlighted MIT’s Hacking Medicine’s Grand Hackfest, which is part of MIT’s Hacking Medicine initiative.  MIT has been at this since 2011, seeking synergies between MIT’s technical expertise and the vaunted Boston-area medical community.  They believe hackers can help health care with: Scaling Medicine, Accelerating Data, Identifying and Tackling Big Opportunities, Hacking Ethos for Lean Medical Innovation, and Infecting Non-Life-Scientists with the Mission. 

Pretty lofty list of goals.

Health 2.0 has their own version, which they call Code-a-thons.  They offer some $6.5m in prizes in their developer challenge, and have several events and challenges scheduled in the next few months.

Goodness knows that health IT has never been known for being either nimble or on the cutting edge, so some fresh blood with new perspectives certainly seems like a good idea, right?  As one clinician whose mobile app benefited from solutions suggested at the MIT hackathon said, "Sometimes when you are too close to something, you stop seeing solutions, you only see problems.  I needed to step outside my own silo.''

Not to be outdone by Boston, New York-Presbyterian Hospital recently held what they claim was the first Hackathon for New York Hospitals, which the specific aim of helping them improve myNYP, their patient portal. Out on the other coast, UCLA-Berkeley has had three iterations of their own version, Hacking Health

Just to rub us oldsters’ noses in it, there’s an organization called YTH (youth + tech + health) that believes the “#selfie generation” can do better. They just hosted their own Health Hackathon in conjunction with their YTH Live 2014 conference.     

The trend is not limited to the United States.  The British National Health Service has NHS Hack Days, in Canada there is Hacking Health, and in Europe there’s CPH Health Connect HackDay in Copenhagen and Hacking Health Stockholm.

Looking back at last fall’s healthcare.gov debacle, or more recent reports of similar issues with various state exchanges, one has to wonder if they just should have held a hackathon.

PwC’s 6th Annual Digital IQ Survey found that healthcare CEOs were far ahead of other industries in championing information technology as an integral part of their strategy.  I rather doubt that many health systems or payors are using hackathons for their big mainframe-based systems – like eligibility, billing, claims payment, or (most) EHRs – but mobile efforts are natural targets for this kind of approach. 

There’s no shortage of targets.  Payors are finding ways to use mobile technology to cut administrative costs, engage members, and manage patients’ care. Still, in a recent Robert Half Technology survey of CIOs, health care led the pack in lacking a mobile strategy.

No wonder they might be looking for hackers.  

It’s great to bring in new ways of attacking the many problems of health care, but I do worry what happens when they hit the may brick walls health care has.  I’ve been seen several instances where non-health care companies – especially financial services firms -- dipped in to health care, thinking they could bring their expertise to bear, only to be shocked at how messy much of the data is. 

What I like best about the hacking in health movement is twofold – bringing in new kinds of expertise and an attitude that problems can be solved.  Those have been sorely missing in health care.  Or, as Mark Twain once put it, “all you need in this life is ignorance and confidence, then success is sure.” 

Hack away!

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting

Friday
Apr042014

April Fool’s Day Brings Some Humor to Healthcare

By Clive Riddle, April 4, 2014

The first of April marked the annual issuance of satirical lists from healthsprocket, zinging a range of current topics in the business of healthcare, which I can’t resist repeating.

First, let’s visit a list of predictions of future major news items, in a list entitled -  Top Healthcare Headlines from Tomorrow's News

  1. Healthcare.gov server achieves singularity, assumes control of planet
  2. Obesity Problem eliminated in United States thanks to Congressional Act to expand BMI ranges
  3. Exchange enrollment count after March 31st deadline exceeds 400 million, last minute inclusion of uncovered domestic pets credited with enrollment surge
  4. Influenza eradicated after development of oral vaccine distributed in Starbucks Coffee
  5. National consulting lobby urges Congress and states to adopt new, confusing and conflicting healthcare legislation - say lack of new laws since Affordable Care Act is stifling consultant job creation
  6. Medicare officially re-named "Johnsoncare" in keeping with Obamacare precedent
  7. Health Plan of San Mateo declared second largest plan in nation after Kaiser-BlueCrossBlueShield-UnitedHealthcare-Human-Aetna-Cigna-HealthNet-Molina-Centene merger

Here’s another list looking into the future, this time predicting what big problems lie ahead a year from now, with the Top Five Healthcare Crises Predicted for 2015:

  1. Acute Shortage of available new healthcare acronyms
  2. Global climate change causes the Cloud holding all healthcare big data to disappear
  3. Demand for health coaches exceeds supply, causing raid on NFL, NBA and MLB staffs
  4. Healthcare exchanges finally end up working smoothly, causing a wide-scale chain reaction of pundits and politicians heads to explode on national television
  5. Lack of funding causes medical homes to downsize to medical apartments

And one more list about upcoming events, this time narrowing the focus to upcoming month, as we consider Healthcare scandals that will surface later this year:

  1. The "two ferns" in the Obama -Zach Galifianakis healthcare.gov interview were secretly switched out with alternative plants provided by medical marijuana lobby
  2. Major healthcare analytics platform discovered to be vintage Magic 8-Ball
  3. Move by major Health Savings Account (HSA) administrators to convert all accounts to bitcoins proves disastrous
  4. Jointly funded XBox, Wii and Playstation study finding health benefits of exercise and fresh air to be vastly overrated, revealed to be based on SimCity and not actual data
  5. High speed disclaimers at end of prescription television ads discovered to be spoken in Klingon language

Speaking of the “Two Ferns” video, next we look at a list that addresses the White House media blitz to promote signing up in the health insurance marketplaces, with New Television Shows Created to Attract the Young Invincibles to Obamacare:

  1. How I Met Your Health Plan - A previously uninsured guy spends nine seasons explaining to his kids how he finally got coverage after years of searching
  2. CSI: Covered Singles Insurance - Each week, investigators track down an uninsured single twentysomething, and bring their health coverage to justice
  3. The Amazing Race - Young uninsured individuals hurry to sign up in a plan before the open enrollment deadline, despite obstacles placed in their path
  4. Modern Family - Different dependent coverage scenarios are explored in each episode
  5. Once Upon a Time - Evil witches try and convince the population to hold out for their fairy tale past of fee for service medicine, house calls, low costs, and happy doctors and patients

And finally, no discussion of the Affordable Care Act is complete without a few zombies thrown in the mix, as demonstrated by the healthsprocket list Upsides for the Affordable Care Act after a Zombie Apocalypse:

  1. Web traffic will not overwhelm healthcare.gov
  2. Annual ACA expenditures will come in under budget
  3. That stubborn "young invincibles" demographic won't be so important
  4. Consumer engagement strategies can be significantly simplified
  5. More of the population will be walking and less sedentary
Friday
Mar282014

March Brings Three Different Slices of Health Plan Consumer Experience Ratings

by Clive Riddle, March 28, 2014

This month, three annual proprietary consumer experience studies have yielded separate slices of the health plan consumer experience. J.D. Power, Temkin Group and Saatmetrix have all weighed in, and each shed favorable light on Kaiser Permanente, among other plans.

J.D. Power released results from their eighth annual Member Health Plan Study, in which they provide member satisfaction index rankings by region. Their 2014 Member Health Plan Study is based on responses from more than 34,000 members of 136 commercial health plans across 18 regions in the United States. The study was fielded in December 2013 and January 2014.  

J.D. Power ranks satisfaction on a 1,000 point scale. Satisfaction is highest among health plan members in the California and Michigan regions (in a tie); the Indiana-Illinois and Mid-Atlantic regions (in a tie); and the East South Central and South Atlantic regions (in a tie). Satisfaction is lowest in the New England, New York-New Jersey and Southwest regions. 

Top ranked plans by region, according to the J.D. Power study, were compiled in healthsprocket, in these regional lists:

J.D. Power 2014 Member Health Plan Study: Top Plan Scores - Southern United Stated

  • Kaiser Foundation Health Plan (784) ranks highest among health plan members in the South Atlantic region (which includes Georgia, North Carolina and South Carolina) for a fifth consecutive year
  • AvMed Health Plans and Humana (in a tie at 690 each) rank highest among health plan members in the Florida region, AvMed ranks highest in the Florida region for a third consecutive year
  • Cigna (689) ranks highest among health plan members in the East South Central region (which includes Alabama, Kentucky, Louisiana, Mississippi and Tennessee)
  • Aetna (677) ranks highest among health plan members in the Texas region

J.D. Power 2014 Member Health Plan Study: Top Plan Scores - Eastern US

  • Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Mid-Atlantic region (which includes Maryland, Virginia and Washington, D.C.)
  • Capital District Physicians Health Plan (727) ranks highest among health plan members in the New York-New Jersey region
  • Geisinger Health Plan (705) ranks highest among health plan members in the Pennsylvania region for a third consecutive year
  • Tufts Associated Health Plans (681) ranks highest among health plan members in the New England region (which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont)

J.D. Power 2014 Member Health Plan Study: Top Plan Scores - Midwestern US

  • Health Alliance Plan of Michigan (711) ranks highest among health plan members in the Michigan region for a seventh consecutive year
  • Dean Health Plan (703) ranks highest among health plan members in the Minnesota-Wisconsin region
  • Medical Mutual of Ohio (697) ranks highest among health plan members in the Ohio region
  • Health Alliance Medical Plans (692) ranks highest among health plan members in the Indiana-Illinois region
  • Wellmark Blue Cross Blue Shield of Iowa (680) ranks highest among health plan members in the Heartland region (which includes Arkansas, Iowa, Kansas, Missouri, Nebraska and Oklahoma)

J.D. Power 2014 Member Health Plan Study: Top Plan Scores - Western US

  • Kaiser Foundation Health Plan ranks highest among health plan members in the California region for a seventh consecutive year, with a score of 756
  • Kaiser Foundation Health Plan (732) ranks highest among health plan members in the Northwest region region (which includes Oregon and Washington)
  • Kaiser Foundation Health Plan (703) ranks highest among health plan members in the Colorado region for a seventh consecutive year
  • SelectHealth (698) ranks highest among health plan members in the Mountain region (which includes Idaho, Montana, Utah and Wyoming) for a fifth consecutive year
  • Blue Cross Blue Shield of Arizona (675) ranks highest among health plan members in the Southwest region (which includes Arizona, New Mexico and Nevada

Temkin Group pronounced the health plan industry “mediocre” and bestowed the highest customer experience rankings to Kaiser Permanente and Humana respectively, in releasing results from their fourth annual ranking of companies based on a study of 10,000 U.S. consumers that “examines the quality of the customer experience delivered by 268 organizations across 19 industries: airlines, appliance makers, auto dealers, banks, car rental agencies, computer makers, credit card issuers, fast food chains, grocery chains, health plans, hotel chains, insurance carriers, Internet service providers, investment firms, parcel delivery services, retailers, software firms, TV service providers, and wireless carriers.”

Bruce Temkin, managing partner of Temkin Group, tells us "consumers give pretty bad ratings to most health plans, as this entire industry needs a customer experience makeover.  Overall, the health plan industry averaged a 56% rating in their study and tied for 17th place out of 19 industries.

Temkin ratings by plans included in the survey were:

  1. Kaiser Permanente (68%)
  2. Humana (63%)
  3. Medicare (62%)
  4. TriCare (62%)
  5. United Healthcare (59%)
  6. Blue Shield of California (58%)
  7. Aetna (57%)
  8. Health Net (55%)
  9. CIGNA (54%)
  10. Anthem (BCBS) (53%)
  11. CareFirst (BCBS) (48%)
  12. Medicaid (45%)
  13. Highmark (BCBS) (44%)
  14. Empire (BCBS) (42%)
  15. Coventry Health Care (41%).

Temkin noted that Humana (+12 points), Blue Shield of California (+7 points), and United Healthcare (+5 points) improved the most between 2013 and 2014. Coventry Healthcare (BCBS) (-18 points), TriCare (-9 points), Empire (BCBS) (-7 points), and Highmark (BCBS) (-6 points) declined the most since 2013. Kaiser Permanente with their 68% rating, was in 109th place overall out of 268 organizations across 19 industries. Humana, with a rating of 63% placed 160th overall. Coventry Health Care (BCBS) was in last place across all 268 companies in the ratings with their score of 41%.

Satmetrix Systems released results for their 2014 Satmetrix® Net Promoter® Benchmarks which measure and rank customer loyalty more than 219 brands across 22 U.S. industry sectors, including financial services, insurance, technology, online services, retail stores, electronics, travel and hospitality, and telecommunications. The Satmetrix Net Promoter Benchmark rankings are based on survey responses from more than 24,000 U.S. consumers nationwide who indicated they had significant experience with a company's products or services in the previous 12 months. A company's Net Promoter Score is based on customers' likelihood to recommend the company's product or service. The score is the percentage of customers who are promoters, rating the company 9 or 10 on a 0 to 10 point scale, minus the percentage who are detractors, rating 6 or lower.

The Satmetrix study for the health insurance sector followed these nine companies:

  • Aetna
  • Anthem
  • BlueCross BlueShield of Florida
  • BlueCross BlueShield of California
  • Cigna
  • Humana
  • Kaiser
  • Medicare
  • United Healthcare

Like J.D. Power and Temkin, Satmetrix found Kaiser Permanente to be a dominant force, leading the health insurance category for the fourth consecutive year  and “improving to an all-time high [Net Promoter Score] score of 40 points. The provider rated highest on a number of important key loyalty drivers, as patients appreciated its service features, company reputation and the feeling that Kaiser Permanente acts in their personal best interest.” Kaiser’s score was 23 points higher than the industry average. Like Temkin, Satmetrix ranked Human in second place: “with a score of 32 points, Humana saw significant improvement from 2013, moving up 14 points to beat out last year's second place finisher, Medicare (27 points).”

Friday
Mar212014

Seated Behind a Health Plan Dashboard

By Clive Riddle, March 21, 2014

Spring has sprung, and if your fancy lightly turns to thoughts of health plans, and in fact you are driven towards such thoughts, a dashboard can be useful. You may be in luck, as Sherlock Company provides a summary from their health plan dashboard as part of their complementary publication, Plan Management Navigator.

Here’s what Sherlock Company reports in their just released March 2014 issue of the Navigator, about the trailing three months ended December 31, 2013, for health plans participating in their dashboard program. Health plans in their Dashboard universe are comprised of Blue Cross Blue Shield and Independent/ Provider-Sponsored Plans.

Health Plan reported “an increase in health revenues of 8.7%. Revenues for Medicaid grew most rapidly, increasing by 17.2%. Medicare Advantage revenue growth followed at 4.7%, while Indemnity product revenues increased 2.7%. ASO/ASC and Managed Care revenues fell by 6.2% and 4.3%, respectively. Overall, membership increased 1.1% for all health lines. Enrollment in Managed Care fell 1.1%, while increasing 1.6% for Indemnity. ASO/ASC membership declined 0.4%.”

“Membership grew in both Medicaid and Medicare by 4.6% and 4.2%, respectively. Both Managed Care and  Medicaid experienced the largest price increases, both at 3.5%. Indemnity followed with a price increase of 1.1%. Medicare Advantage products had a price decrease of 2.3%, while ASO/ASC posted a decline of 5.3%.”

“Health benefit ratios for health lines deteriorated by 2.0 percentage points to 90.0%. Managed Care and Indemnity had the largest increases of 5.4 percentage points and 4.5 percentage points, respectively. The number of scripts per person increased by 0.4 to 9.5 on an annualized basis. E/R visits per thousand members fell 13.4 to an annual rate of 241.8 per thousand, while hospital days also increased by 21.2 days to 335.1 days per thousand. The administrative expense to premium ratio increased 0.6 percentage points to 11.8%, while the administrative costs per member per month increased 2.3% to $34.76. Claims volumes increased 0.87 to 17.7 per member per year, while inquiries per member grew 0.34 to 1.9 per member per year. Staffing ratios fell 0.32 FTEs per 10,000 members to 21.1.”

You can click here if you’d like to subscribe to Sherlock Company’s complementary Plan Management Navigator, which includes additional articles full of great health plan data, benchmarks, and insights like those provided in the Dashboard Summary.

Wednesday
Mar122014

Content Marketing Dominates Social Media Trends in 2014 

By Claire Thayer, March 12, 2014

There continues to be a very strong focus on Content Marketing as a vehicle for educating current customers as well as for attracting new business opportunities. White papers and sponsored emails are considered the two top tactics for generating leads, along with sponsored webinars, according to a recent survey conducted by Business.com of more than 500 of its active pay-per-lead advertisers on questions related to lead generation tactics and strategies.  Specific to White Papers, more than 50 percent of those surveyed said white papers are a “valuable” or “extremely valuable” source of leads:

This week, Business 2 Community posted their 13 Social Media Marketing Trends in 2014, on the top of the list -- content marketing -- 

As you consider your White Paper strategy, here a few good resources that might be helpful:

We of course would love to engage with you in a conversation about our own ideas  to help you power your White Paper strategies! Drop your contact info here at any time and we’ll send you a few ideas to think about!