My main job is president of Health Business Group, a boutique healthcare strategy consulting firm I founded in 2003. As a sideline, I write the Health Business Blog, where I provide a behind the scenes look at the business of healthcare, featuring my spin on healthcare topics in the news, interviews with entrepreneurs, and policy prescriptions.
Tufts Health Plan CEO Tom Croswell is a veteran of the health plan world. I sat down with him to discuss value based care, collaboration, diversity and how Tufts tries to set itself apart in a crowded market. Tufts is best known for serving Massachusetts but is also expanding into neighboring states. It has a joint venture in New Hampshire and had just announced its entry into Connecticut in partnership with Hartford HealthCare.
The news was full of stories about merger discussions between Partners HealthCare and Harvard Pilgrim Health Care. No one denied the reports, so we can assume there was some truth to the rumors. But why would these organizations contemplate a merger and how likely would it be to happen? I compared it to a scene from a Cheech & Chong movie.
A month after Harvard was talking about merging with Partners, the company’s CEO was out. It had something to do with his behavior… Both the Globe and Herald wanted to hear what I had to say about departed CEO, Eric Schultz.
Nurse triage lines have gone through three phases of evolution. In phase 1 they were implemented to ‘check the box’ for member education, phase 2 brought “demand management” to keep patients out of the emergency room, and now in phase 3 health plans are creating a gateway to innovative programs and services.
I discussed these topics with a leading company in the field.
We don’t normally think of Senator John McCain as a healthcare leader, and yet he played a significant role over the years in various policy matters. CareCentrix CEO, John Driscoll and I paid tribute in a short edition of #CareTalk.
Pharmacy Benefit Managers (PBMs) claim to keep drug costs under control, but their convoluted business models and tactics don’t always result in the best deal for employers. Reference based drug pricing is an interesting alternative approach. It’s used for drug cost control in other parts of the world and within the US for things like elective surgery.
“Consumer directed health plans” were all the rage in the mid 2000s. The big idea was that if patients had ‘skin in the game’ in the form of greater financial participation in the cost of their care, they would use their well honed shopping skills to find the best deals and thereby drive costs down and value up. Employers embraced the idea, since it could reduce their costs and keep employees happy.
Healthcare was on the minds of mid-term voters in November. Candidates emphasized healthcare in their campaigns and voters in at least six states had an opportunity to weigh in on healthcare via ballot questions.
Voters were being asked to decide some fairly technical questions, including whether dialysis center profits should be capped in California, whether hospitals should have to maintain specific nurse staffing ratios in Massachusetts, and whether Medicaid eligibility should be expanded or current expansions extended in Idaho, Utah, Nebraska and Montana.
In this end-of-2018 edition of #Caretalk, Carecentrix CEO John Driscoll and I banter about Amazon, drug pricing, immigration, home health, Russia, the ACA and more. I wanted to call this episode “If You Want to Destroy my Healthcare” but was told the Weezer reference was too obscure.
The term ‘Medicare for All’ is being bandied about as the campaign for the Democratic Presidential nomination gets underway. Declared and potential candidates are warming to the idea. It’s easy to see why.
However, I’d much rather see attention turn to continued expansion of Medicaid, specifically by offering people the opportunity to ‘buy-in’ to Medicaid coverage.
Biotech company Agenus is launching a “digital security offering” that will let people invest directly in a single biotech product, rather than the whole company. Jeff Ramson, founder and CEO of strategic communications firm PCG Advisory Group, became fascinated by the concept and reached out to me to discuss it, even though he is not involved in the offering. (And neither am I.)