Category Archives: health reform

World Health Care Congress 2019

by Nick van Terheyden MD and Gregg Masters MPH

One ritual on the punch-list of many thought leaders (in both capital ‘P’ policy and operational theaters) and innovators in the healthcare transformational conversation is the work of Vidar Jorgenson, et al, producing and curating the World Health Care Congress annual gathering in our nation’s capital.

Health Innovation Media was on the ground with our #pinksocks pop-up studio in 2018. We live streamed our audio featuring top talent including former Chief Technology Officer of the United States under the Obama Administration and President, Care Journey Aneesh Chopra, then Assistant Medical Director and CMIO, Kaiser Permanente, Southern California John Mattison, MD and former Chief Innovation Officer and Executive Vice President of UPMC, now EVP and Chief Strategy Officer of Atrium Health Rasu Shrestha, MD, MBA.

Aneesh Chopra, President Care Journey

Audio from our live streaming of World Health Care Congress 2018 can be previewed on demand. Day one is here, and day two here.

This year our colleague Nick van Terheyden, MD aka ‘Dr. Nick‘, served up an agile version of our pop-studio and managed to tap top talent in the mix including: Craig Samitt, MD, MBA, President and CEO of Blue Cross Blue Shield, Minnesota, Martin Makary, MD, Professor of Surgery and Chief Islet Transplantation, Johns Hopkins Medicine, Robert Pearl, MD, former CEO of the Permanete Medical Group and author of ‘Mistreated: Why We Think We Are Getting Good Healthcare – And Why We’re Usually Wrong‘ and Former Secretary of the Veterans Administration, the honorable David Shulkin, MD.

I especially appreciate Dr. Samitt’s sober commentary on the apparent failure of industry wide innovation efforts to restrain the persistent appetite of our production driven healthcare economy, and it’s strain on the budgets of the American people including Federal, State and local governments. Dr. Samitt’s candor brings to mind a 2014 post on ACO Watch titled: ‘‘Eating Glass?’: A DaVita Healthcare Partners Hiccup or Impending Physician Integration Implosion?’ Take a look, in my biased opinion it’s worth the read.

Enjoy!

Finally! @ONC_HealthIT & @CMSgov ‘Drop’ Interoperability & Empowerment Regs #NPRM

Bt Gregg A. Masters, MPH & Fred Goldstein, MS

At the @HIMSS pre-conference NHIT Summit this morning, the National Coordinator for HealthIT Donald Rucker, MD, (follow via @donrucker) broke news at the Health Information Management Systems Society (HIMSS) in Orlando, Florida.

While the community expected the Notice of Proposed Rule Making (NPRM) ‘might drop during HIMSS, Fred and I were happy to witness and document this long expected regulatory proposal.

Later in the morning Peter Ashkenaz, Director of Media Affairs at Office of the National Coordinator for Health Information Technology (ONC), released the following fact sheet‘.

Enjoy the raw footage!

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The Grandfather of Health Policy on the Moral High Ground for CAPG

by Gregg A. Masters, MPH


My first encounter with Leonard Schaeffer was back in the day when CMS was known as ‘HCFA‘ (the Healthcare Financing Administration) and the Federal commitment to the HMO (and emerging PPO) industry was tracked by a small staff huddled inside the ‘Office of Alternative Delivery Systems‘. Leonard Schaeffer was serving as HCFA’s Administrator. As such his seat was front and center as the uniquely American public/private partnership sought to deal with healthcare’s increasingly problematic and growing share of GDP (then in the 7-8% range).

Upon exiting his Government service Schaeffer was poised to lead the massive extension of managed healthcare into mainstream medicine via two principal market dynamics: 1) the introduction of the ‘Prudent Buyer Program‘ a PPO, followed by the 2) Conversion of Blue Cross of California (a non profit licensee of the Blue Cross and Blue Shield Association – Blue Shield is and remains today a separate (now taxable) entity in California), which then morphed into WellPoint and now Anthem empire.

Blue Cross of California dabbled in the HMO space, but for the most part deferred to the likes of Maxicare (eventually HealthAmerica, before the bankruptcy filings), FHP, Healthcare USA, Health Plan of America, HealthNet and PacificCare, (and their risk savvy medical group partners – Mullikin, Facey, Bristol Park, Harriman Jones, Friendly Hills et al) etc., instead leaning on and into it’s PPO products to lead the transformation of American medicine from UCR (usual customary and reasonable) to contracted or discounted medicine.

I worked on the provider side for flagship non-profits  including: St Joseph Medical Center, its faith based parent – the Sisters of Providence, and later the for profit hospital chain ‘AMI‘ (American Medical International) 1/2 of the partnership that gave birth to Tenet Healthcare, and finally the academic medical center UCI Irvine in the city of Orange.

This chat at the just concluded Annual Meeting of CAPG (California Association of Physician Groups) in San Diego is a lengthy but must see bit of important health policy history that contextualizes the glide-path in a way few are capable of recounting. Schaeffer is perhaps the ‘grandfather’ of US Healthcare innovation and has unique standing to comment on the past, rate the present state of progress 5 years into the ACA, as well as forecast a probable future for the industry writ large as well as the unique role entities such as CAPG (risk savvy players) can play.

 

See original commentary below and source link here:

Leonard D. Schaeffer presented the keynote talk, Health Care Reform: A 50-State Experiment, at CAPG’s Annual Healthcare Conference. Mr. Schaeffer was founding Chairman and CEO of WellPoint (now Anthem) from 1992 through 2004 and Chairman through 2005. Currently the Judge Robert Maclay Widney Chair and Professor at USC, he previously was President and CEO of Group Health, Inc. of Minnesota; Administrator of the Health Care Financing Administration (now CMS), and Assistant Secretary for Management and Budget, U.S. Department of Health and Human Services.

Cinderblocks2: Day One

by Gregg A. Masters, MPH

Cinderblocks2 kicked off today in Grantsville, Maryland. Dubbed ‘burning man’ for healthcare disruptors the day included an across the pound Skype chat between patient advocates awarded crowd funded scholarships at Doctors 2.0 in Paris and Cinderblocks and concluded with fire dancing, song and a lighed walk across a bridge with 350+ candles in mason jars reflecting each jacket and personal story included in the walking gallery.

Here’s a visual recap of only some of the jam packed day!

Tomorrow’s pace shows no let up….

Details here.

Cinderblocks2: The Partnership With Patients Continues From Grantsville Maryland

by Gregg A. Masters, MPH

Described by none other than Regina Holliday herself to be the ‘Burning Man for healthcare disruptors’ this event will draw a determined gathering of ‘skin in the game’ participants from e-patients, to health wonks and even some clinicians.

For a preview of Cinderblocks2 including the motivation and history behind the event click here.

More to be added as the ‘real time’ schedule unfolds. Follow via twitter and engage with us via hashtag #cinderblocks2.

Cheers!

 

HiMSS 2015 a 206 Second Tour!

By Gregg A. Masters, MPH

Producing relevant, timely and quality digital content – whether word (blog, website or micro-blogging aka twitter), video (recorded or live) or audio (live or podcasted) takes both time and commitment.

In the vast healthcare ecosystem – sometimes affectionately referred to as ‘the healthcare borg’ – there seems to be an endless stream of conferences perhaps tethered at some level to the hierarchical structure of organized (some might say dis-organized) medicine as reflected by the 24 member American Board of Medical Specialties (ABMS), which slices and dices the attention span of it medical labor pool and in turn drives the culture and chasis of the medical industrial complex from doc to lab technologist.

Graft onto this multi-layered structure the many overlapping if not cross silo interests associated with the likes of digital medicine, telemedicine or telehealth, genomic medicine, precision medicine, health information technology or ‘mHealth’ and you add volumes to the digital rivers created by conference organizers each clamoring for relevance in their chosen space.

I had intended to author several takeaway pieces wrapped around the many interviews we conducted at HiMSS 2015, but time and competing interests elsewhere have precluded my ability to deliver at least to this point in time.

The interviews will be produced and published over time, but in the gap here is a 206 second tour of HiMSS 2015 with many cameo appearances of social media savvy participants including many I am honored to call friends.

Cameo appearances @RasuShrestha @HealthyThinker @eFuturist @Ahier @HealthcareWen @WestShell3 @PhilMarshallMD @Validic @JeanAnneBooth @UnaliWear @Ascension @Cerner @DrNic1 @SJDMD and more.

Enjoy!

 

Lown’s In Town

By Gregg A. Masters, MPH

Shannon Brownlee 2013 National Healthcare Innovation SummitI’ve been following the Lown Institute since shortly after chatting with Shannon Brownlee at the Healthcare Innovation Summit in Washington, D.C. in 2013 which ran concurrently with the ACO Summit.

As press covering the event for @ACOwatch, I asked Shannon for an interview as a result of watching her interview on Escape Fire the documentary about America’s healthcare ‘borg’.  Shannon graciously granted the interview below:

A side note, I was not able to publish the edited video of this exchange due to a sea of competing priorities for a start-up in the health reform and emerging transformational healthcare economy.

So when I saw Lown coming to town (i.e., San Diego), I dove back into the narrative that serves as both context and oxygen for the mission of this determined ‘value oriented’ entity:

Lown Institute mission

What’s both tragic yet durable in this continuing conversation is: it’s 2015 and we’re still talking about the ‘whack-a-mole’ problems associated with a ‘purchase order’ driven healthcare eco-system yet to find and promulgate a ‘systemic remedy’.

And the fact the ‘we kill our best’ certainly in metaphoric terms which applies to some of the credible voices in that ‘over treatment’ and imploding house of cards healthcare non system narrative – particularly as articulated by a national treasure who somehow didn’t rise to the level of ‘credentialed standing’ to be honored with the title ‘permanent’ Director of the Centers for Medicare and Medicare Services – none other than Donald Berwick, MD (one of my ‘truth to power’ heroes).

To both frame and stage the narrative and seemingly intractable challenge, watch the trailer from the 2012 movie ‘Escape Fire’ which where I first learned of Shannon Brownlee:

Meanwhile, fast forward to 2015 and examine the flare at this ambitious yet well ‘staffed’ gathering:

Lown Institute Kickoff San Diego

The complete agenda for the conference is available here. Also you can follow the conference ‘digital dashboard’ via hashtag #Lown2015 for tweets, analytics and digital reach of the conference as well.

I plan on attending the event on Tuesday and Wednesday with my colleague and Health Innovation Media co-host, Douglas Goldstein aka @efuturist.

If you are faculty, organizer or underwiter of the conference and you want to spend some ‘camera time’ with us, ping me on twitter via @2healthguru, or drop me a line via gregg(at)healthinnovationmedia(dot)com.

Remember, it ‘takes a village’ to reform our healthcare borg.

Meanwhile join the Lown Institute and sign the ‘declaration’ for the ‘RightCare’ movement here.

 

JP Morgan 2015: Strategic Tea Leaves from the Non-Profit Track

By Gregg A. Masters, MPH

Most who follow the JP Morgan Healthcare extravaganza search for clues to short, long term or even nano second high frequency trading equity plays – witness the flurry of pre-event ‘news’ releases, ‘how to follow’ the event tomes, preferred ‘investment themes’, and ‘what to expect’ guides, etc. Yet from my perspective the ‘below the radar’ value from this gathering is the strategic insight to be gleaned from the trophy and lesser known 501(c)3 or their derivative for profit JVs or affiliates sharing their vision, approach and results to a market with tectonic shifts in its midst.JP Morgan Non Profit Track Companies

Trophy nameplates the likes of Kaiser Permanente, Cleveland Clinic, Ascension Health, Sutter Health, Advocate Health, and Intermountain Healthcare seed an impressive class of variably mature operators with varying relative success in the integrative delivery system and risk contracting and management theatre.

As ‘uptake gatekeepers’ if you will, for many of the innovations – whether HealthIT, biotech, biopharma or care delivery (population health, care management, etc.) related, these systems are excellent proxies for indicia if not the profile of granular value adds enabling a sustainable healthcare ecosystem.

The rapid proliferation of ‘innovation centers’ organized under ‘Chief Innovation Officers’ with line operational authority and a mission to disrupt legacy or ‘this is how we do it’ institutional inertia evidences the priority of the ‘triple aim’ in the healthcare C-suite.

Provider-led health plans: The next frontier—or the 1990s all over again?

As you watch and/or listen to some of these reports (including that which is NOT said), consider the following recent report issued by Mckinsey as it drills into the macro environment as well as the operating weeds of health systems pursuing an ‘integration strategy’ via acquiring or building a health plan group in its operating portfolio. The timely report is titled: ‘Provider-led health plans: The next frontier—or the 1990s all over again?’

Getting it ‘right’ this time may be the last ‘kiss at the apple’ to salvage the public/private partnership  as principal host of the U.S. health system. How these systems vision, structure and pursue the triple aim, i.e.,  better care, better outcomes at lower per capita cost will in larger measure determine the industry’s collective success.

As noted by one of the report authors:

‘This is clearly a segment we should be paying attention to…There has been a lot of discussion wondering if the market is just a repeat of the 1990s… I think time will tell, but there are three or four reasons why I think it could be different than the 1990s.’  Gunjan Khanna, PhD

For additional context if not insight from an ACO or accountable care perspective, see: ‘Universal American: No Where in Sight at JP Morgan Healthcare Conference 2015’.

JPMorgan Healthcare Conference 2015: 33 Years Later We’re Still Searching…

By Gregg A. Masters, MPH

JPM15_home_registrationIt looks like this will be the third year in a row that I participate albeit via 2nd level engagement ‘touch points’ in the proceedings principally via side bar event or private party invite [or crashing], the rich twitter stream and a most generous schedule of webcasted company presentations. To follow the free JPM 2015 webcasts you can register here (simple email registration is required).

As someone trained in the behavioral sciences and public health or its more contemporary version framed as ‘population health’ where the focus is on the health and wellbeing of whole populations, I rarely follow niche biotech, pharma or medical device investment themes per se. Rather, I am singularly interested in monitoring the vision, strategy initiatives and outcomes reported by a rather heterogeneous cohort otherwise grouped by JP Morgan under a ‘non profit companies’ track – mostly tax exempt health [hospital] systems. While many of these entities may be virtually indistinguishable from the for-profit brethren, how they organize, partner, joint venture or chose to extend beyond their core businesses [or not] is always a fascinating story. Further, as ‘uptake gatekeepers’ if not the customer for many of the innovations presented by participating companies at JPM15, measuring their sentiment or ‘buy-in’ is one way to gage the likely relevance of the product, service, platform or ‘IP’.JPM15_non profit track

Following the passage of the Affordable Care Act it’s fair to say that we’re in the midst (albeit early) of a fundamental restructuring of an arguably $3 trillion ‘cottage industry.’ Seeded originally under the pillars of ‘cost plus’ for hospitals and ‘usual, customary and prevailing’ charges for physicians we created a supply driven perfect storm of a silo-ed healthcare [non] systems incentivized or perhaps addicted to more. Where do more meant, earn more. That is now changing and everyone agrees that ‘business as usual’ is no longer an option. The question is what is the footprint of these new, emerging or re-tooled business models and who are the value added partners that enable the expression of ‘new term sheet’ success at scale?

With that in mind, I reviewed the line-up for this year and note the following partial list of companies reporting in the non-profit track. Be mindful that for these links to work you must register before opening them. There is a contextual story (provider type, market characteristics, risk tolerance and prevailing culture) to each of their reporting. For example, I am most interested in the post merger vision of Baylor and Scott and White, where a group practice medical group centered IDN has affiliated with a more traditional albeit progressive hospital system. Who’s cultural DNA will prevail post merger?

Good luck and enjoy!

Also, the twitter hashtag is #JPM15. Follow the dashboard here and follow me on twitter via @2healthguru.

 

The ‘Non Profit Track’ Participating Companies

JPM15 Non Profit Track Webcasts
http://jpmorgan.metameetings.com/confbook/healthcare15/nfp_companies.php

Ascension

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Ascension&p=17295&special_list_title=

Advocate Health Care

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Advocate+Health+Care&p=17303&special_list_title=

Adventist Health System

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Adventist+Health+System&p=17316&special_list_title=

Baylor Scott & White Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Baylor+Scott+%26+White+Health&p=17298&special_list_title=

Barnabas Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Barnabas+Health&p=17311&special_list_title=

Catholic Health Initiatives

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Catholic+Health+Initiatives&p=17305&special_list_title=

Trinity Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Trinity+Health&p=17356&special_list_title=

Partners HealthCare System

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Partners+HealthCare+System&p=17296&special_list_title=

Mercy Health (formerly Catholic Health Partners)

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Mercy+Health+%28formerly+Catholic+Health+Partners%29&p=17317&special_list_title=

Legacy Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Legacy+Health&p=17375&special_list_title=

Kaiser Permanente

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Kaiser+Permanente&p=17508&special_list_title=

Geisinger Health System

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Geisinger+Health+System&p=17300&special_list_title=

Dignity Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=Dignity+Health&p=17310&special_list_title=

University of California Health

http://jpmorgan.metameetings.com/confbook/healthcare15/company.php?company=University+of+California+Health&p=17304&special_list_title=Not-For-Profit%20Companies

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The Walking Gallery Center for Arts and Healing

by Gregg A. Masters, MPH

On the day before Thanksgiving we spoke with Regina Holliday  (@ReginaHolliday) to get updated on her work and plans for the near term including a conference to be hosted in her rural Maryland location timed with ‘Health Datapalooza’ or its re-branded version in 2015 and the current crowdfund listing for The Walking Gallery Center for Arts and Healing, see Neil Versel’s (@nversel) ‘Holliday’s ‘Walking Gallery’ Seeks MedStartr Cash for Healing Center‘ in @Forbes.

On the broadcast I was joined by my co-host Dr. Phil Marshall (@PhilMarshallMD) for what was a collegial and thoughtful exchange on EHRs, Meaningful Use and the state of the U.S. connected health backbone.

For direct link to Medstartr listing for The Walking Gallery Center for Arts and Healing, click here or on the thumbnail below:

Medstartr_The Walking Gallery2

Some notable tweets included: 

Having a wonderful discussion today on #twihi with @ReginaHolliday …see #thewalkinggallery and listen in: blogtalkradio.com/healthtechmedia

Cool @ReginaHolliday signed ‘giant release’ with @KPShare to ‘talk about her as their patient..’ Few know about this… #TWiHI

What’s wrong with this picture? 350+ jackets & only 37 backers. bit.ly/1F0dduk #TWiHI pic.twitter.com/hnsbyOPQ34

Of 350+ jackets in #TheWalkingGallery @ReginaHolliday painted 310 (?)! She needs help tweepls! Support via bit.ly/1F0dduk #TWiHI

as do all of us with jackets. #thewalkinggallery Center for Arts & Healing is for all of us @ReginaHolliday

A 5% threshold a very low bar for uptake of #EHRs [paraphrased] @ReginaHolliday #TWiHI