Health Business Blog

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

Remedy Partners founder Steve Wiggins explains why he’s high on bundled payments (podcast)

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Remedy Partners founder Steve Wiggins

Steve Wiggins has seen a thing or two in his more than three decades as a healthcare entrepreneur. His Oxford Health Plans introduced “pods,” a precursor of the Accountable Care Organization and he led HealthMarket, an early player in the consumer directed health plan space. He’s carried the same themes into his current  role as founder and Chairman of Remedy Partners, the leader in Medicare’s Bundled Payments for Care Initiative (BPCI).

As you’ll hear in this podcast, Steve’s a big believer in bundles, offering them as a proven solution for a large portion of the healthcare dollar, within almost any healthcare financing framework from traditional commercial coverage to Medicare for All.

Here’s what we discussed:

  • (0:18) What is a bundled payment? How does it relate to other new approaches like ACOs?
  • (3:05) Did bundled payments start in Medicare rather than the private sector? If so, why?
  • (6:52) How well has BPCI worked? What does the future look like?
  • (11:01) How do episodes and bundles tie in more broadly? I often hear that chronic care or end of life care are the big cost drivers, not episodic care. Can those statements be reconciled?
  • (15:10) How should we think about bundled payments and related topics playing into the campaign, or should we just give up on that?
  • (19:14) You’ve founded quite a few healthcare companies over your career. How does this Remedy compare?
  • (21:41) How do you expect the company to evolve in the next few years?

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

Lifespan tries to keep Partners out of RI. I’m quoted in the Boston Globe

Big bad Partners HealthCare plans to take over Rhode Island’s number two player, Care New England. Lifespan, the market leader is trying to keep Partners out by appealing to Rhode Islanders’ resentment of out-of-state players and claiming to have the public interest at heart.

“This is not about Lifespan,” [Lifespan’s CEO Dr. Timothy] Babineau said in an interview. “This is about the future of health care in Rhode Island.”

Actually, Lifespan seems to want to go from being the big fish in a small pond to the only fish, by merging with Care New England and Brown, in a so-called “unified” health system, which is just another word for monopoly.

I call them out in the Boston Globe (Lifespan says Partners takeover of Care New England would cost R.I.)

“Lifespan has correctly identified the threat to themselves — but the idea that that is a threat to the public interest is another matter,” said Williams, president of Health Business Group.

“It’s kind of an obvious move to attack a big company for being from out of state, and [saying] they’re going to hurt our local economy and drive up costs,” Williams said. “Really what’s happening is [Lifespan] would like to dominate Rhode Island and not have to worry about somebody else.”

PS –It’s kind of funny that the Boston Globe itself has announced its intention to penetrate Rhode Island with more coverage of local matters. Watch out Providence Journal!

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

You’ve come a long way baby! And thanks to Ovia, your mom’s employer knows all about it

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There’s an app for that

The Denver Post (Tracking your pregnancy on an app may be more public than you think) has published an interesting and disturbing article about the rise of Ovia, an app that collects detailed and personal data from pregnant women and those hoping to conceive. I’m not surprised that the business model is to provide data to employers about their workforce in order to save on medical costs and reduce time away from work. But I am a little surprised at how much data employees are willing to enter on topics like their sex life, color of cervical fluid, miscarriages and so on, while the app also track things like what medical conditions they looked up.

“Maybe I’m naive, but I thought of it as positive reinforcement: They’re trying to help me take care of myself,” said [Diana] Diller, 39, an event planner in Los Angeles for the video-game company Activision Blizzard. The decision to track her pregnancy had been made easier by the $1 a day in gift cards the company paid her to use the app: That’s “diaper and formula money,” she said.

As I remind people using “free” apps –or ones they are paid to use– you’re not the customer, you’re the product. There’s plenty written on this topic so I won’t bother to rehash it here, but it’s worth remembering that the data provided by Diller and others can be combined with tons of other data from their use of Google, Facebook, Waze, exercise trackers, and more to create incredibly detailed and personal profiles.

In 2008 I wrote a brief blog post called Baby formula in the mailbox. “Honey, is there something I should know?” I was puzzled to see that it still gets a lot of hits in 2019 and that readers are still commenting about their own experiences. Back then, an au pair who worked for us had received baby formula from Abbott Nutrition. Somehow, some marketer thought she was pregnant. It was kind of embarrassing and of course could be problematic for a family relationship or if the pregnancy had ended prematurely.

Online data gathering has come a long way in the past decade. If Abbott once guessed you were pregnant, imagine how much more they –or many others– knows about you now. Maybe the users of these apps aren’t naive, just fatalistic about the idea that everyone knows everything anyway, so why not just take the formula and diaper money and run?

In a few years, Diller’s child will probably find the Denver Post article or maybe even this blog post. If that person is you, I’d be interested to know how you feel about it.

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

 

#CareTalk March 2019: Gottlieb’s out. What’s next for FDA?

The latest edition of #CareTalk is out. CareCentrix CEO, John Driscoll and I explore the departure of FDA Director Scott Gottlieb and other pressing topics.

Here’s what we covered:

(0:28) Scott Gottlieb is out at FDA. Are you sad to see him go?

(2:00) Home health spending is projected to grow faster than any other category of healthcare over the coming years. Is that good or bad?

(4:00) Insulin prices are spiking and both Democrats and Republicans are up in arms. What’s happening?

(5:53) Lyft is talking about the social determinants of health. What?!

(8:47) What do you think about FDA approving ketamine nasal spray as a treatment for depression?

(9:10) What did we learn about healthcare from Michael Cohen’s Congressional testimony?

(9:33) Medicare has a new app. Have you tried it?

(9:59) Did you hear about the $48,500 bill for a cat bite?

Subscribe to the #CareTalk Podcast
iTunes: https://apple.co/2DIDTcr
Google Play: https://bit.ly/2RobqMB

Interoperability in healthcare 2019: Podcast interview with Rhapsody

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Interoperability has a been a buzzword in healthcare for about a decade, but sometimes it doesn’t seem like we’ve gotten that far. In this podcast, Rhapsody’s EVP of Product & Strategy, Drew Ivan and I discuss interoperability: its past, present and future.

Here’s what we covered:

  • 0:20 What is interoperability anyway?
  • 2:50 Why do we hear about interoperability so much in healthcare? Is it an issues in other industries?
  • 5:11 How does interoperability in the US compare to the situation elsewhere?
  • 6:51 Does interoperability matter to patients?
  • 9:20 Has interoperability failed in the past? What new models are being tried?
  • 11:54 What’s the business model for interoperability?
  • 13:42 Are there any downsides? Does interoperability create any new problems?
  • 14:54 How will interoperability evolve in the coming year?

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