Health Business Blog

Health care business consultant and policy expert David E. Williams share his views

Check out #CareTalk @HLTH2019

CareCentrix CEO, John Driscoll and I talk #CareTalk on the road to the HLTH conference in Las Vegas, where we interviewed some big names include Obamacare architect Zeke Emmanuel, Former CMS Administrator Andy Slavitt, Former Congressman Patrick Kennedy, Walmart Health exec Marcus Osborne, and Boston Children’s Chief Innovation Officer John Brownstein.

You can check out the whole series on the YouTube playlist.

The healthcare cost revolution will not be televised either

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Coming to a TV near you

The quote at the end of yesterday’s Boston Globe article (Consumers struggle to find information on health care costs, poll shows) made me laugh.

“We’re seeing more and more consumer awareness every year,” [an insurance executive] told the Globe. “It’s a revolution that’s occurring, but it occurs over time.”

When I read about this ‘revolution’ it brought to mind an expression/poem/song from long ago: The Revolution Will Not Be Televised! The timeframe for the healthcare cost ‘revolution’ is on the order of decades, and I don’t think anyone will be able to sit still for a TV show of that length!

Not surprisingly, the Pioneer Institute’s survey demonstrated that while people with commercial insurance are interested in obtaining  price information before receiving a healthcare service, they don’t often get it. Only 2 to 7 percent of people check costs on insurers’ websites, according to the Attorney General.

Although that number seems crazily low, it’s actually easy to understand once you consider the multitude of the barriers:

  1. Patients don’t know what services they’re going to need
  2. Choice of provider often trumps cost as a factor
  3. Their health plans may not reward or punish them for saving or spending more money
  4. Next year’s insurance premiums are unaffected by what they do this year
  5. Those with a high deductible plan are likely to blow through the deductible anyway if they have serious medical expenses
  6. Insurers’ cost estimators aren’t easy to use
  7. The estimates may not be accurate anyway
  8. People haven’t heard about the available tools

I’m an educated consumer with a high deductible plan but I don’t try to check the costs ahead of time.

So there’s no need to be glued to your TV (or other device) watching this ‘revolution.’


By healthcare business consultant David E. Williams, president of Health Business Group.

Drug testing –the new back to school ritual

I guess I spaced out and forgot to post this episode of #CareTalk back in September, when it came out! I thought I could John to partake of the specimen cup but he refused.

In this video we cover Trump’s “phenomenal” health plan, drug testing of students, medical tourism, obesity and back to school resolutions.

Enjoy!

Future of Health Data –the Big Brains convene!

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Katyal, von Eschenbach, Shulkin and Siddiqui

A quiet revolution is underway in healthcare data. A decade after the HITECH Act spurred the rapid adoption of electronic medical records, we are seeing the resulting data being integrated with other sources such as insurance claims, clinical registries and social determinants of health to produce richer data sets for analysis and action.

As we’ve noted in our own consulting work, Datavant has emerged as a key player in connecting disparate data sources at the patient level while protecting privacy. The company’s methodology anonymizes patient identifiers with a unique patient key, matches records across data sets, and enables data exchange.

So I was excited to attend Datavant’s Future of Health Data Summit in Washington, DC earlier this month. As one would expect from a company that strives to organize and present data efficiently, accurately, and clearly, it was a quality event. The day featured 40-minute panels with strong moderators and 3-4 expert panelists along with keynotes from luminaries such as former FDA Commissioner Robert Califf, CDER Director Janet Woodcock, and former Senate Majority Leader Tom Daschle.

The closing panel, Healthcare Policy, Value-Based Care and Data Sharing was typical of the program. Moderator Neal Katyal (former Acting US Solicitor General) made the most of the expertise of panelists David Shulkin (Former VA Secretary), Mona Siddiqui (Chief Data Officer, HHS) and Andrew von Eschenbach (former FDA Commissioner).

They were all passionate about the ability to finally leverage healthcare data at scale. Shulkin talked about using data to prevent suicides of veterans. The highest incidence is in the first year after discharge, when they risk falling between the cracks as they transition from the DoD to VA system. Siddiqui bemoaned the difficulties of confronting the opioid crisis with 2-year old data, and von Eschenbach spoke of the potential to transform the whole healthcare system by improving care and reducing costs.

Shulkin seemed the most skeptical about where things are headed in the near term, predicting incremental change in the healthcare system as the most likely outcome of the fight between Medicare-for-All Democrats and Republicans who want to crush federal involvement. When Siddiqui gushed about the potential to use the planet’s largest healthcare data set (from CMS) in hackathons and challenges and system redesigns, Shulkin interjected that working with the government was, “not for the feint of heart,” and “,not a great strategy for a young company.”

There was an interesting back and forth about how to get the public comfortable with data sharing, how to overcome the decline of public trust in general, and how to address privacy from a policy and technological standpoint.

The panelists generally agreed that patients would be on board if they saw how use of data could help with their own care, and that even spectacular data breaches wouldn’t completely erode patients’ trust in the system. We have become accustomed to such breaches with our financial data, after all.

Shulkin thought people would get really upset if they learned that their data was for sale. I disagree -I think consumers are already coming to terms with their data being sold throughout the rest of the information economy; it’s by no means unique to healthcare.

In closing, von Eschenbach said he was “incredibly optimistic” due to the tremendous energy coming into the process right now. It’s a chaotic environment, he said, but we’ll look back in five years and be grateful for today’s chaos.

Shulkin pointed to the large number of healthcare data companies formed over the past three years, using that as an indicator of the level of optimism in the field. It wasn’t evident to me that he fully shares this optimism.

And Siddiqui presented herself as a realist but also a bit of a visionary and optimist, who is thinking about the healthcare system that we want to have. For her –and many of us– it’s one that’s more technology enabled, virtual care enabled, and homecare centric.

I’m heading to the HLTH conference in Las Vegas next week. I hope it’s as worthwhile as the Datavant event!


By healthcare business consultant David E. Williams, president of Health Business Group.

What gets measured gets done. So be careful what you measure!

When I read ‘Fear of Falling’: How Hospitals Do Even More Harm By Keeping Patients in Bed I was reminded of the old adage, ‘What gets measured gets done.’

In this video I lay out three solutions to the problem of overzealous pursuit of fall reduction:

  1. Keep the measure but change the target so we’re not aiming for zero falls
  2. Add a new measure of how much patients are getting up and walking
  3. Reduce the penalties for excessive falls

What do you think?

By healthcare business consultant David E. Williams, president of Health Business Group.