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13
May

Cloud-based Healthcare Analytics and Decision Support Solutions


CostTransparencyThe old playbook no longer works. Everyone acknowledges that U.S healthcare is broken.

Technology (preventative apps like Apple Health and HealthKit; EHR, claims and reimbursement analytics; Physician Practice management etc.)  will reinvent healthcare as we know it.  I expect the  healthcare transformation to start incrementally and develop slowly in sophistication.  Though the early changes will appear clumsy and underwhelming, by 2030 they will seem obvious, inevitable and well beyond the changes we might envision today.

Why change? Consider this:

  • Honeywell, a Fortune 100 technology and manufacturing company, needed to manage the ever-escalating cost of insuring its 130,000 employees and their dependents. Honeywell has reported that health care costs were growing approximately 8-10% per year.
  • Self-insured employers like Wal-Mart want to make health care cost and quality information available to their 1.2 Million employees.  Useful information that can be used by employees to select physicians based on how their rank, or how much they cost, resulting in savings for both the employee and the employer. Decision support enabler.

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12
May

Consumerism, Health Exchanges, and Payor Big Data – A Primer


EmployerRequirementsHealthcare Benefits are the 2nd costliest line item for companies in the U.S. So, companies are taking aggressive steps to reduce this spend. Consider this:

  • IBM is moving to a private health exchange…Extend Health private exchange will be handling plan options for 110,000 IBM retirees
  • Walgreens is moving employees to a Corporate Health Exchange. Of the 180,000 Walgreen employees eligible for healthcare insurance, 120,000 opted for coverage for themselves and 40,000 family members. Another 60,000 employees, many of them working part-time, were not eligible for health insurance.
  • Trader Joe’s  — decided to send some employees to the new public exchanges. Trader Joe’s has left coverage for three-quarters of its work force untouched but is giving part-time workers a contribution of $500 to buy policies. Because of the employees’ low incomes, the company says it believes many will be eligible for federal subsidies to help them afford coverage.

For the past year I have done strategy and implementation work in the employee Healthcare benefits and Private Exchange area.  I wanted to share my insights into the massive structural changes taking place in health insurance. The move to patient-centered, consumer-driven, and value-based models is real.

This posting has been updated and posted on disruptivedigital.wordpress.com

 

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