e-CareManagement Blog
Archives for e-CareManagement Blog (2006-2021)
The Future of Platforms in Healthcare — Updated PowerPoint
by Vince Kuraitis and Shahid Shah
We are pleased to offer you our updated perspectives on the future of platforms in healthcare.
Click here for a copy of our joint presentation at the 9th Annual Healthcare Unbound Conference. This is an update from our earlier joint presentation at the eCollaboration Forum as part of HIMSS 12.
What’s different in the marketplace over the past few months? Three key observations:
1) The trend toward platform adoption is accelerating and becoming more clearly understood. The requirements of Stage […]
Good or perfect: Cutting the fastest path forward
Guest post by Patrick Gordon, Director, Colorado Beacon Consortium
Early pioneers to Colorado did not have the luxury of waiting for railway or infrastructure to be in place before taming a new frontier. Their vision and determination laid the foundation for the settlers who followed. They used the tools and talents they had to develop an infrastructure and ultimately build viable, productive communities. Had they waited for the perfect conditions, they’d still be back east.
It’s a lesson we’ve […]
Hospitals or Health Plans: Who Do You Trust to “Connect” You with Your Health Records?
Over the past decade, I’ve seen a number of studies asking people whom they trust among various health care stakeholders. Nurses, pharmacists, and doctors always come out at the top. Beyond that:
Trust of hospitals tends to be high (60–80%)
Trust of health plans is at the bottom of the heap (10–20%)
Is this written in stone for the future? I don’t think so…and the dynamics for change are in motion. Please read on.
Here’s the emerging picture I’m seeing:
Hospitals are dragging their feet in […]
The ACO Antitrust Police — Nothing to Do
One of the biggest concerns about ACOs has been their potential to enable market consolidation— that by uniting health care providers the ACO gains market clout and ability to charge higher prices.
While this is a legitimate concern about ACOs, so far it’s not playing out.
Why?
Medicare Announces 27 ACOs. A New Species?
I’m surprised and intrigued by Medicare’s announcement of 27 new Shared Savings model ACOs.
Surprised
I had been anticipating this announcement as a defining moment for Medicare’s thrust into accountable care. My expectations had been that we would see either:
Boom — a big splash of new Medicare shared savings ACOs announced, including big name hospitals and medical groups that were starting large scale ACOs, perhaps with hundreds of thousands of patients.
Bust — no one showed up at the party. Providers would have […]
Will Health Plans Want to Contract with ACOs? Maybe, Maybe Not.
On the Perficient Health IT blog, Christel Kellogg writes:
I am hearing that carriers are staying away from ACOs and are not planning on partnering. What have you heard?
This is one of those blip-on-the-radar-screen comments that jarred my attention — and it raises very important questions about industry dynamics.
First, let me expand on the issue. As I’ve written before, there are at least two broad categories of “accountable care initiatives”:
1) Formal Accountable Care Organizations (ACOs) by which care providers contract with Medicare
2) Informal Accountable […]
A 6th Difference Between ACOs and “AC-Like” Arrangements
Last week I wrote about five key differences between formal ACOs (mainly care providers contracting with Medicare) and informal Accountable Care-Like (AC-Like) arrangements between care providers and commercial health plans.
Transaction costs
Timing
Incrementalism
Flexibility
Capital cost
There’s an important 6th difference worth noting:
Visibility
Formal ACOs will be visible from miles away — think elephants on the Serengeti.
An ACO that wants to contract with Medicare must establish itself as a corporation. The Medicare ACO models have substantial disclosure and reporting requirements. We won’t know […]
St. Patrick’s Day Edition of the Health Wonk Review
Head on over to Boston Health News to read the latest in health wonkery! Tinker Ready greets us with the St. Patrick’s Day Edition of the latest and best coming from the health care blogosphere.
Platforms Have Potential To Reshape Markets RAPIDLY!
Let’s look at the U.S. smartphone operating system (OS) market as an example.
In 2007, Apple iOS and (Google) Android had a collective market share of 0%.
Today they have a collective market share of 77%.
What’s the Difference Between ACOs and “AC-Like” Arrangements?
A lot. AC-Like arrangements will be MUCH simpler to create and maintain.
The health care market is moving toward accountable care. There are at least two broad paths forward:
1) Formal Accountable Care Organizations (ACOs) by which care providers contract with Medicare
2) Informal Accountable Care-Like (AC-Like) arrangements between care providers and commercial health plans
What are the differences between these routes? I see at least 5 factors at play:
Transaction costs
Timing
Incrementalism
Flexibility
Capital cost
Stage 2 MU Rules: Shifting Competition from Hoarding to Sharing
Competition today in healthcare encourages care providers to hoard patient data.
That’s inefficient, ineffective, and just plain wrong.
But we’re seeing light at the end of the tunnel — the proposed Stage 2 Meaningful Use (MU) rules reinforce new, evolving accountable care payment approaches. The rules support moving competition in healthcare to the right bases — sharing and adding value to patient health record data.
Today: Competition Based on Hoarding Patient Data
Health care providers today have incentive to hoard patient health record information. They might phrase it as:
I don’t get paid to share […]
NeHC Webinar, March 5: Implications of a Shifting National HIE Architecture
Implications of a Shifting National HIE Architecture
March 5, 2012 @ 1:00PM Eastern
COURSE DESCRIPTION: A recent paper by Dr. Les Lenert published in the Journal of the American Medical Informatics Association (JAMIA) has prompted a flurry of debate in the HIT industry and across a number of social media outlets about the shifting sands of the national HIE strategy. Join a number of HIT thought leaders as we take this discussion from Google + to the NeHC University stage […]
“The Future of Platforms in Healthcare” — PowerPoint from eCollaboration Forum at HIMSS12
My colleague Shahid Shah and I are glad to make available to you a copy of the slides from our upcoming presentation “The Future of Platforms in Healthcare.” This presentation takes place at the eCollaboration Forum as part of HIMSS12 on Thursday, February 23.
You can access the slides here.
While the eCollaboration Forum in Las Vegas is sold out, you can still sign up for the live webinar all day Thursday, February 23: http://eCollab12.eventbrite.com
Here’s a brief summary of our presentation “The Future of Platforms […]
eCollaboration Forum at HIMSS12 — SOLD OUT! 2/23 Webinar Still Available
The inaugural eCollaboration Forum taking place at HIMSS12 on Thursday, February 23, 2012 in Las Vegas is SOLD OUT!
A webinar is available to those who will not be in Las Vegas: http://eCollab12.eventbrite.com
Theme — Collaborative Platforms and Applications in Health Care
This is the Health IT industry’s first-ever event focusing on collaborative health platforms and applications! We take an expansive view of platforms and will be exploring the required technologies, business ecosystems, and clinical care delivery needed to achieve accountable care.
It is […]
Latest Health Wonk Review at Healthcare Economist
Jason Shafrin hosts the latest edition of the Health Wonk Review on his Healthcare Economist blog. Check it out!
Platform Failure and Success: Lessons from Outside Healthcare
Healthcare is just starting down the road of adopting platform technology and business models. What lessons can we learn from other industries?
A recent article by Andreas Constantinou in Vision Mobile blog provides guidance. The article lists a Dead Platform Graveyard from the past 10 years — you will probably recognize some of the names: Meego (Nokia/Intel), Palm 5/6, Symbian OS (Nokia) WebOS (HP), Windows Mobile (Microsoft). Blackberry RIM is a candidate to make next year’s list.
Software platforms have failed for a […]
Survey Says: Yes, National HIT Architecture is Shifting, Thank Goodness!
Brian Ahier sparked a feud with his Google+ post commenting on a recent JAMIA article entitled Shift in the Architecture of the Nationwide Health Information Network. We’re at 60+ comments and going strong. The discussion has also been picked up on in Modern Healthcare.
The JAMIA article was written by Leslie Lenert and colleagues, and Lenert joins in heartily in the Google+ discussion. From the abstract, here are 3 key points they make:
1) …a significant change in the architecture of the NwHIN is […]
Healthcare Apps: Just Scratching the Surface of the App Economy
The headline in yesterday’s LA Times declares:
‘App Economy’ credited with creating 446,000 jobs.
What’s the App Economy?
Op Ed: Emanuel NYT Editorial is Irresponsible and Naive
Zeke Emanuel’s editorial in the New York Times — The End of Health Insurance Companies — really got my blood boiling. It’s irresponsible and naive. Former Obama advisor Emanuel “predicts”:
By 2020, the American health insurance industry will be extinct. Insurance companies will be replaced by accountable care organizations — groups of doctors, hospitals and other health care providers who come together to provide the full range of medical care for patients.
Irresponsible
Provoking and demonizing health plans might have had populist appeal and political value in […]
“Platforms” for Accountable Care, a “Must Have”, Not Just a “Nice to Have”
What do Amazon, Apple, Facebook and Google have in common?
Eric Schmidt, Chairman (and former President) of Google, coined the term “Gang of Four” in referring to the similar platform/application technical architecture and business models of these companies. In the case of Apple iOS and Google Android OS, much of the value is created by the 500K+ applications built on these platforms, not just by the platform themselves.
So four of the largest, most successful companies in the world are built on platforms — […]
Announcing the Inaugural eCollaboration Forum at HIMSS12!
Please consider attending the inaugural eCollaboration Forum taking place at HIMSS12 on Thursday, February 23, 2012 in Las Vegas at the Venetian Sands Expo Center.
Theme — Collaborative Platforms and Applications in Health Care
This is the Health IT industry’s first-ever event focusing on collaborative health platforms and applications! We take an expansive view of platforms and will be exploring the required technologies, business ecosystems, and clinical care delivery needed to achieve accountable care.
Speakers
Sponsored by HIMSS and Collaborative Health Consortium (formerly the Clinical […]
Op-Ed: ACP Doctors, Thank You for Acknowledging a Law of the Universe
Resources are finite. They just are. This is not an opinion, it is a law of the universe.
Yet, for my lifetime, I have been incredibly frustrated by medicine’s cultural and practical lack of acknowledgement of this law.
FINALLY, the American College of Physicians (ACP) got it. Kaiser Health News describes the revelation:
The American College of Physicians hit a nerve when it released an updated ethics manual calling for doctors to provide “parsimonious care” – in other words, “to practice effective and […]
Welcome to the Blogosphere! Voice on Population Health
The Care Continuum Alliance announces a timely new blog: Voice on Population Health.
Tracey Moorhead, President and CEO of the Care Continuum Alliance, writes today’s inaugural post. She persuasively notes the increasing importance of the full continuum of population health interventions – wellness, prevention and other approaches to improving health, reducing disease risk and raising productivity.
Bob Laszewski’s essay on today’s THCB resonated with me: 2012: A Year of Huge Uncertainty in Health Care Policy. In my 30 years in health care, I have […]
Holiday Shopping Guide Edition of the Health Wonk Review
Check out the best of health care policy punditry on the Wright on Health blog. Brad Wright hosts the latest edition of the Health Wonk Review.
Getting An Epic Opinion Off My Chest
We need to be far more explicit in asking a subtle but critical question
What are acceptable bases of competition in health care?
My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:
It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors
It’s NOT OK for care providers to compete on the basis of controlling or limiting access […]
Leavitt ACO Report: Overstating or Understating Accountable Care Activity?
Accountable Care Organizations (ACOs) have been likened to
a unicorn — a fantastic creature that is vested with mythical powers. But no one has actually seen one.
a camel — a horse designed by a committee, one that already has its nose in the tent
With this background, you can begin to appreciate the difficulty of conducting an accurate census of ACO animals in the wilderness. Yet, this is exactly the task undertaken in the excellent Leavitt Partners report measuring ACO activity in the US.
As I […]
The EHR|HIE Interoperability Workgroup — Potentially Earth-Shattering
Yesterday’s announcement of “Standard Health Data Connectivity Specifications” by the EHR|HIE Interoperability Workgroup (EHR|HIE WG) is potentially earth-shattering.
My mom would not know what I mean by “Standard Health Data Connectivity Specifications,” so I’ll try to write this in plain English.
Who Are These Guys? The EHR|HIE Interoperability Workgroup
The workgroup consists of HIEs (Health Information Exchanges) representing seven of the largest states, eight EHR vendors, and three HIE software/services vendors.
Employers Perceive that Health Plans Add Value to ACOs
A just released study from Aon Hewitt and Polakoff Boland — 2011 Employer Driven Accountable Care Organizations Survey Report — examines employer attitudes toward ACOs. The report provides useful insights into an area that hasn’t yet received much attention.
A couple tables in particular caught my attention.
(click on the graphic to view a larger version)
Key findings in this table include:
HealthCamp Oregon, Oct 22 — Hope to See You There!
.
.
.
by Nate DiNiro
HealthCamp Oregon is organizing 2 events during the 3rd week of October in Portland, Oregon. The events will focus on Healthcare, Health IT, the ePatient & Participatory Medicine movement and all-things Healthcare Transformation!
The first event, a panel that will focus on the impact of social media in healthcare, is scheduled for Thursday 10/20. We’re also helping to promote the annual Kaiser Center for Health Research Saward Lecture, scheduled for Friday 10/21. More information on that event can be […]
Six Quick First Impressions of the CMS Bundled Payments for Care Improvement Initiative (BPCII)
This afternoon CMS announced the Bundled Payments for Care Improvement Initiative (BPCII). For details, start reading here.
Here are six quick first impressions:
1. It’s very creative and innovative. CMS has demonstrated out-of-the-box thinking and leaves a lot of room for applicants to propose their own approaches. Expect to have to read the materials 2-3 times to wrap your thinking around it.
Unlike the Medicare Shared Savings ACO rule, the BPCII is flexible. Anticipate some innovative and non-traditional proposals from diverse applicants. Unlike […]
The Practice of Medicine: from Marcus Welby to ???
by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA
Physicians face great uncertainty. According to a survey conducted by The Physicians Foundation, the great majority of physicians (89%) believe the traditional model of independent private practice is either “on shaky ground” or “is a dinosaur soon to go extinct.”
In the face of this uncertainty, many physicians are jumping to a conclusion that “I have to sell my practice to the hospital.” In this post of our series on The […]
Heatwave Edition of Health Wonk Review
Check out the latest Health Wonk Review written by Julie Ferguson at the Workers’ Comp Insider blog. Cool down and review summaries of the best writings of the healthcare blogosphere. Thanks, Julie!
Physician-Hospital Relationships: The Hospital Morphs from Revenue Center to Cost Center
by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP
In our introductory posting of this series, we noted that economic incentives previously aligning doctor-hospital interests were changing. This creates the potential for The 100 Year Shift – physicians awakening to possibilities for stronger partnerships with payers than with hospitals.
In this post, we will zero in on the changing economic position of hospitals and the effect this is having on physician-hospital relationships. We will examine the […]
Will Health Plans Continue to Buy Up Hospitals?
I doubt it.
IMHO, the recent acquisition by Highmark Blue Cross Blue Shield of West Penn Allegheny Health System (WPAHS) for $475 M is unique to local market conditions. It was done as a last resort and should not be taken as a signal that health plans are starting a hospital buying binge.
Why are hospitals unattractive investments for health plans:
Platform Wars!
Click here or on the graphic to download a copy of my July 11 presentation from this year’s Healthcare Unbound conference.
Google+ Shines the Light on the Value of Data Portability
It’s understandable that a healthcare delivery system would have a mindset and business objective to keep referrals within its network of care providers. Businesses have a right and an obligation to try to hang on to their customers.
It’s a different issue whether closed or walled garden HIT is an acceptable means toward that end.
Outside of healthcare, we understand and can accept that businesses used closed, proprietary IT as part of their business model. Apple has designed their […]
Payment Transformation: From Volume to Value
by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA
In our introductory posting, we suggested that a huge shift is underway in the health care industry. Decades of hospital-physician cooperation are not only eroding, we suggest this trend could accelerate. Instead of a natural clinical and economic affinity with hospitals, we foresee the potential for physicians forming a new dyad with insurer-buyers.
In this post, we will examine what we and many other commentators view as inevitable: the demise of […]
The 100 Year Shift? Introduction and Overview
by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP
Gazing at the horizon, we foresee the potential for a tectonic realignment among physicians, hospitals and payers. Here’s a quick visual representation:
This essay is the first of a seven part series. In this first post we will capsulize our vision of this potential 100 Year Shift, answer initial FAQs, and lay out the structure for the rest of the series.
The Lynchpin — Changing Economic Incentives
In the past, physicians and hospitals […]
Could Google+ Be Your Platform for Care Coordination?
An earlier post — Could Facebook Be Your Platform for Care Coordination? — resonated well with folks.
Readers and commenters (on e-CareManagement and The Health Care Blog) quickly grasped that a social networking platform could play a very useful role in coordinating our health care, yet also agreed with the conclusion that Facebook wasn’t “it”.
So let’s ask the question again: Could Google+ be your platform for care coordination? This post will
Describe Google+ and Circles
Discuss how Google+ gets past some of Facebook’s limitations as a […]
Patient “Leakage”: Rethinking Two Field of Dreams Assumptions About ACOs
A study released last week by the Massachusetts Attorney General contains surprising data to challenge two commonly held ACO (accountable care organization) “Field of Dreams” assumptions. These assumptions relate to patient “leakage” — out-of-network patient care and referrals.
1) Hospital administrators assume that tighter physician-hospital integration (e.g., through employment of physicians) will result in “captive referrals” by physicians back to the mother-ship hospital.
2) Medicare administrators are assuming that Medicare Shared Savings ACOs will be able to coordinate patient care even without limitations on patients’ choice to go […]
Trend Spotting: 1) Medicare ACO Dead-in-the-Water, 2) Payers Awaken to ACO Opportunities
It’s time to call it — the Medicare Shared Savings (SS) ACO is dead-in-the-water.
Ironically — at the same time — commercial payers are awakening to ACO opportunities.
Please read further.
Aetna, Cigna, Wellpoint Recreating Their Business Models
Major U.S. health insurers, including Aetna Inc., Humana Inc. and WellPoint Inc., are retooling to become more than just health plans, in the wake of the federal health-care overhaul that is changing the rules for the industry’s core business.
Diversification plans, touted in meetings with investors this year, include stepped up acquisitions and partnerships that will allow the companies to employ doctors directly, deliver health-information technologies, and participate in new hospital-doctor groups known as accountable-care […]
BlogTalkRadio Interview — Is Hospital-Physician Alignment Sustainable?
Why have hospitals increasingly been buying physician practices? Are these marriages based on true love or convenience? Will these marriages survive?
To address these questions, let’s take the long view (50–100 years) and revisit 7 assumptions that have driven us to today’s healthcare non-system:
Healthcare payment systems have rewarded piecemeal work.
Despite uneasiness, hospital-physician relationships have been cooperative.
Physicians can function effectively in small/medium size practices.
The healthcare mindset: built on control, not collaboration.
Barriers to sharing patient info and coordinating care are high.
The hospital has been the economic bedrock […]
“The Top Ten Things You Need To Know About Engaging Patients”…and the Why
Hi all, my name is Howard Rosen (Founder & CEO of LifeWIRE Corp), co-author of the recently published white paper report entitled “Top Ten Things You Need To Know About Engaging Patients.” You can access a copy here through the Institute for Health Technology Transformation (scroll down to “Whitepapers”.)
According to the Pew Internet and American Life Project, 88% of American adults with Internet access research health information online and 60% say Internet info influenced a decision about how […]
Is Hospital-Physician Integration Sustainable?
Reprinted courtesy of MCOL.
Perspectives on a Selected Key Topic | April 2011/May 2011 | Volume Three Issue Two
Will a material number of hospitals and their core medical […]
Lesson for Healthcare: Disrupt Your Own Business Model Before Someone Does it TO YOU
Healthcare needs positive role models for innovation…and we have a real-time mentor in Netflix.
If you have a Netflix subscription, you probably identify with the company as providing a convenient DVD rental service — order on the web, the DVD arrives by mail, send it back in the handy pre-paid envelope when you’re done.
Today’s ReadWriteWeb describes Netflix’ latest letter to shareholders and explains how the company is preparing for the demise of DVDs:
Part Deux: A Rebuttal to PHR Luddites
By now most people understand the promise of pharmaceuticals being customized to “YOU” based on your individual genetic code. While this isn’t prevalent today, we understand that this will be possible in a few years.
Let’s take a minute to consider the mechanics of how this will occur. You’ve received a prescription, and it directs the pharmacist to tailor the medicine to YOUR genetic profile.
Consider two possible scenarios of how this transaction might happen. You’re on the phone with your pharmacist:
1) “OK, […]
A Rebuttal to PHR Luddites
Unlike some of my colleagues, I’m not losing ANY sleep over whether personal health record (PHR) systems ultimately will be adopted and used by patients.
In my mind, the issue isn’t WHETHER, but WHEN.
Yes, I know that adoption has lagged and that surveys suggest 7% or less of the U.S. population has used a PHR.
Stay with me on this one for a minute. You’d have to have two underlying beliefs to conclude that PHR systems won’t eventually emerge:
That health record data will persist […]
Through the Lens of Disruptive Innovation: Why Direct is a Hit and PCAST is an Outcast
(click on the graphics to link to original sources)
Regular readers know that I find Professor Clay Christensen’s theory of disruptive innovation to be a useful lens to explain industry evolution. Let’s look at two recent health IT initiatives and see why one is working and the other is stalled.
Could Facebook Be Your Platform for Care Coordination?
My guess is you’ve probably never asked yourself this question. A quick preview:
Technical barriers aren’t the limiting factors to Facebook becoming a care coordination platform.
Facebook’s company DNA won’t play well in health care.
Could Facebook become the care coordination platform of the future? If not Facebook, then what?
1) Technical barriers aren’t the limiting factors to Facebook as a care coordination platform.
Can you imagine Facebook as a care coordination platform? I don’t think it’s much of a stretch. Facebook already has […]
List of Top 10 Health Plan Issues — Out of Whack!
Healthcare IT News just published its list of top issues for health plans in 2011:
Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.).
Care Management, Data Analytics, and Informatics.
Health Insurance Exchanges and Individual Markets.
New Provider Payment & Delivery Systems (ACOs, PCMHs, etc.).
Bend the Cost Trend.
Medicare and Medicaid.
Health Information Exchanges and EMRs.
Consumer’s Role in the Modernization of Healthcare.
Reform Uncertainties.
Payer/Provider Interoperability.
Dear health plan colleagues,
Wake up! The order of this list is totally out of whack.
#2: Care Management, Data Analytics, Informatics. Good…sounds about right.
However,
#2 can’t […]
Tire Kickers Need Not Apply: 8 First Impressions of the Medicare ACO Rule
On March 31, CMS released the long-awaited “Medicare Shared Savings Program: Accountable Care Organizations” document (ACO Rule). Read the details here (strong suggestion: unless you’re working on your PhD in ACOs, start with the fact sheets).
There are many surprises. Here are eight first impressions on this 429 page tome:
The bar has been set high…very high. Tire kickers need not apply.
Don’t expect to see many or any small ACOs.
Patients will be confused by ACOs.
Concerns over maintaining competition and avoiding antitrust are […]
ACO Roundtable on blogtalkradio: Friday, April 1
On Friday April 1st, 2011 (yes, ‘April Fools day’) at 4 PM Eastern and 1 PM Pacific
ACO Watch: A Mid Week Review will host a special roundtable series on the ‘hot of the press’ Notice of Proposed Rules’ pertaining to the implementation of Accountable Care Organizations. For the published rule, click here.
The roundtable team will consist of Mark Browne, MD, PYA, aka @consultdoc, Vince Kuraitis, e-Care Management blog, aka @VinceKuraitis, and David Harlow, the Harlow Group, LLC, aka @healthblawg, with Gregg Masters, aka @2healthguru, as moderator and host.
To listen live, […]
The New ACO Rule is Here…The New ACO Rule is Here…and more!
429 p. Proposed ACO Rule
ACO Fact sheet from HHS
Medicare Fact Sheet: What Providers Need to Know
HHS press release
Don Berwick’s article on ACOs in the NEJM
ACO Quality Performance Standards Summary
FTC/DOJ Joint Antitrust Statement on ACOs
TheHill article “Leaked memo reveals Dem strategy for defending healthcare reg”
The leaked memo
A One in a Hundred Whitepaper: “Better to Best” Transcends PCMH, Care Coordination, Access, HIT, and ACO Payment Reform
Let me try to get you in the right frame of mind to read one of the most remarkable white papers in a long time: Better to BEST: Value Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations — released yesterday by the Commonwealth Fund, Dartmouth Institute, and PCPCC.
Having been a debater in high school and then trained as a lawyer, my default mode of thinking is to be critical:
“Hey, Vince, how ya doin’? Great day isn’t […]
The 6th Thing to Watch in the Medicare ACO Regulations
Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week. Politico
What should you be looking for as you snuggle by the fireplace this weekend reading the draft ACO regs?
Rob Lazerow writes a helpful article listing 5 Things to Watch in the Medicare Shared Savings Program Proposed Rule. […]
Health Plan Strategy Options in Two Sentences
“If you’re a health plan, you either become a care delivery system or an information services company,” said David Brailer, a former George W. Bush administration health official who now leads an investment firm. “The traditional business is dead.”
Read more at Kaiser Health News.
.
The Crucial Distinction Between “Accountable Care” and ACOs
While in Philadelphia earlier this week, my colleague Dr. David Nace presented me with a print copy of McKesson Relay Health’s newest whitepaper — Providing Accountability: Accountable Care Concepts for Providers. I felt honored as he handed it to me and confided that it was one of only six copies in print. I took time to read it carefully on the long flight home.
The whitepaper is a great overview of accountable care and ACOs (Accountable Care Organizations). It’s a quick and easily digestible read.
However, there is one […]
Electronic Health Information Exchange — Way More Complicated Than Getting Money from an ATM
“If banks can exchange funds electronically through the ATM system, why can’t my doctor and hospital exchange information electronically?”
Keith Boone’s concise article “A Doctor is Not a Bank” explains why this conclusion about healthcare interoperability is overly-simplistic.
…and Keith’s article reminded me of an even deeper explanation presented in the National Academies’ Frontiers of Engineering series — Why Health Information Technology Doesn’t Work, by Elmer Bernstam and Todd Johnson. The table below summarizes the differences between health data and banking data.
e-Newsletter Archives
Archives for e-CareManagement News (1999-2006)
Commentary – Lifemasters Pulls the Plug on Oklahoma Medicare Health Support Project
Christobel Selecky, Executive Chairman of Lifemasters, announced yesterday that Lifemasters was ending participation in its Oklahoma Medicare Health Support (MHS) project. The announcement was made to an audience at the Care Continuum Congress held in Washington, D.C.
The Next Big Thing – Hospital at Home
I hereby predict the Next Big Thing is hospital at home (HAH).
How do I know this? My primary source is my wife, Jill. Both of our children — now age 18 and 21 — were born by C-section during the golden era of indemnity insurance. I remember Jill practically begging her doctor to get the insurance company to authorize a few extra days in the hospital so that she could rest and recover.
I asked her how she would handle that […]
Will Physicians Collaborate or Compete with DM Companies?
Doctors, before you get mad, let me acknowledge that the word “compete” isn’t in most physicians’ vocabularies. Doctors relate much more to a culture rooted in service and professionalism rather than business competition.
The medical home concept being advanced by primary care physicians could wind up competing with disease management (DM) companies. Ironically, this occurs at a time when most DM companies are picking up the pace of improving relationships and communications with doctors.
While the medical home model isn’t new, it […]
Resources and Commentaries – Medicare’s Chronic Care Improvement RFP
It’s the event of the year — if not the decade — for U.S. organizations involved in disease management or chronic care. On April 23 the Center for Medicare and Medicaid Services (CMS) released a request for proposal (RFP) inviting organizations to bid on Chronic Care Improvement pilot projects under Section 721 of the Medicare Modernization Act.
While the RFP has generally been viewed very positively, there are many potential pitfalls, particularly for organizations that do not have significant experience at […]
Audioconference an Update on Medicare’s Chronic Care Improvement Program
Please participate in Tuesday’s audioconference on the new Medicare Chronic Care Improvement Program! fyi, you can review my PowerPoint presentation Strategies for Winning a Contract: The CMS Chronic Care Improvement Phase I RFP.
Best of health,
Vince Kuraitis
Principal
Better Health Technologies, LLC
Press Release:
CMS Provides Update on the New Medicare Chronic Care Improvement Program in National Disease Management Audioconference
Tuesday, May 25, 2004
1:00 pm – 2:30 pm (Eastern)
12:00 pm – 1:30 pm (Central)
11:00 am – 12:30 pm (Mountain)
10:00 am – 11:30 am (Pacific)
Press Release
Contact: Paul […]
The View Down the Road – Baby Boomers Will Benefit From “Healthcare Unbound” Technologies
Forrester Research recently coined the term “Healthcare Unbound” to encompass the technology-enabled shift toward self-care, mobile care, and home care. The Center for Aging Services Technologies recently facilitated a demo day for members of Congress and showed examples of “Healthcare Unbound” technologies beginning to enter the marketplace.
Skeptics might point out that “If you look in the rearview mirror at the road we’ve traveled over in the past few years, consumer technologies haven’t had much on impact on health care.”
….and they […]
E-CareManagement News
Disease Management News Reprint
Expect Greater Use of eHealth in DM in 2004
7 Key Trends Focus on Integration of Technologies,
Convergence of Devices
1) Cost Management Will Continue to Be the Primary Driver of DM Technology Adoption
2) Predictive Modeling Technologies Will Focus on “Impactability”
3) Information and Communication Technologies Will Enable DM Assembling as a Viable Business Strategy
4) Consumer Electronics Giants Will Bring DM into the Living Room
5) Remote Patient Monitoring and Wireless Technologies Will Enable “Healthcare Unbound”
6) Personalization Technologies Will Allow Patients to […]
“Expect Greater Use of eHealth in DM in 2004 – 7 Key Trends Focus on Integration of Technologies, Convergence of Devices” Disease Management News Reprint
Cost Management Will Continue to Be the Primary Driver of DM Technology Adoption
Predictive Modeling Technologies Will Focus on “Impactability”
Information and Communication Technologies Will Enable DM Assembling as a Viable Business Strategy
Consumer Electronics Giants Will Bring DM into the Living Room
Remote Patient Monitoring and Wireless Technologies Will Enable “Healthcare Unbound”
Personalization Technologies Will Allow Patients to “Have It Your Way”
The Electronic Health Record Will Break From the Pack
We hope you enjoy the digital reprint article (Adobe Acrobat format):
This article appeared in the […]
Evidence-Based Medicine is Pivotal in Advancing Care Management
Evidence-based Medicine and Managed Care: Applications, Challenges, Opportunities
Results of a National Program to Assess Emerging Applications of Evidence-based Medicine to Medical Management Strategies in Managed Care
Vanderbilt Center for Evidence-based Medicine, December 2003
Health plans touch all facets of healthcare and therefore have a unique opportunity to stimulate adherence to evidence-based practices….The purpose of this program was to explore how managed care is applying principles and concepts of evidence-based medicine to its delicate balancing of cost and quality management.
Some of the key […]
Today’s Great Idea – The Continuity of Care Record
While attending the Mobile Healthcare Alliance meeting earlier this month in Minneapolis, I was introduced to a brilliant, yet simple concept — the Continuity of Care Record (CCR).
The usefulness of the CCR struck me like a BFO — a blinding flash of the obvious. Two speakers — Peter Waegemann, CEO of the Medical Records Institute, and Claudia Tessier, Executive Director of the Mobile Healthcare Alliance — eloquently described and advocated for the CCR.
The CCR is a concept quietly being developed […]
Healthcare Unbound: Convergence of Consumer and Healthcare Technologies
The Opportunity
Consumer healthcare technologies are driving opportunities to serve patients in new ways and in new settings. Forrester Research recently coined the term “Healthcare Unbound” to encompass the trends toward self care, mobile care, and home care. More specifically, Forrester Research describes Healthcare Unbound as “technology in, on and around the body that frees care from formal institutions.”
In addition to dramatically changing traditional healthcare delivery, Healthcare Unbound attracts a range of companies that previously have not been deeply involved in […]
Sustaining E-Health in Challenging Times
Report on the Fourth Annual eHealth Developers’ Summit, April 2003
This report summarizes the discussions held during the Third Annual eHealth Developers’ Summit in November 2002. Some key findings include:
Consumers and health care organizations are perceived to be the major eHealth players in the short-term, but government influence on eHealth seems to be increasing.
Consumers, with few exceptions, are still unwilling to pay for online health information or services, thus consumer-oriented eHealth products will need to incorporate incentives in their business models […]
Change Your Thinking About Heart Disease and Cancer
Stereotypes of two medical conditions — heart disease and cancer — are changing. Recent stories in The New York Times, The Washington Post, and The Wall Street Journal describe how mainstream thinking is being challenged.
The New York Times quotes Dr. Claude Lenfant, Director of the National Heart, Lung and Blood Institute. “In the old days, you had a heart attack and you died…. You were almost signing the death certificate in advance. Now you know you can get another 20 […]
Remote Patient Monitoring Inching Its Way into DM
Disease Management News Reprint
Remote patient monitoring (RPM) promises to be the next evolution of the digital age in health care. More than 75 companies are developing RPM offerings. While many of these are start-ups, the field has also attracted large, established companies such as Medtronic, GE, Phillips, Siemens, EDS, and others.
This article appeared in the October 10, 2002 print edition of Disease Management News.
The publisher of Disease Management News, National Health Information, will make FREE 4-issue trials available to the […]
Welcome to Our New Format!
For the first time, this edition of E-CareManagement News is being sent out in HTML (graphical) format. If your email program can read HTML, then you should be viewing this edition with color and graphics. If you are having trouble viewing this newsletter, it’s also available at the BHT website. Please bear with us while we fix any bugs and please let us know if you have problems reading the newsletter.
If this issue of E-CareManagement News was forwarded to you […]
DMPC Realigns Its Business Model – A Major Step Forward!
Who’s really influential in the world of disease management (DM)? You don’t have to go very far before you bump into the name of Al Lewis, Executive Director of the Disease Management Purchasing Consortium (DMPC).
Don’t let his grin fool you. Alfred B. Lewis (Al) is a shrewd businessman….and getting shrewder every day. This article will describe how Al has recently realigned the DMPC business model and how this change will benefit both DM vendors and health plans.
In a nutshell, the […]
Broadband and E-Health: Joined at the Hip
“Slow broadband deployment is the key limitation in our high technology economy.” Andrew Grove, Chairman, Intel
Here’s a pop quiz — the answer might surprise you: What percentage of US households have high-bandwidth Internet connections? What percentage of South Korean households? (Answer below)
Several recent reports have examined the compelling advantages of broadband (high-speed) Internet and have highlighted some of the most promising health care applications. This brief reviews key excerpts and highlights some of the surprising findings.
Broadband: A 21st Century Technology […]
Cats and Dogs Living in Harmony? The CFO and CMO have Common Interests in Disease Management
A quiet, yet dramatic disconnect has existed in many health care organizations for the past decade. The disconnect relates to how the Chief Financial Officer (CFO) and the Chief Medical Officer (CMO) view disease management (DM).
This subtle dynamic has impacted the course of disease management development and implementation in many provider and health plan organizations. In many organizations CFOs took a predictable point of view — “Show me the money.” In other words, they would only endorse DM programs if […]
Client Spotlight – Cardiobeat Poised to Revolutionize Hemodynamic Monitoring
Cardiobeat is an early stage company with a revolutionary impedance cardiography system for non-invasive measurement of hemodynamic (blood flow) parameters. Impedance cardiography holds great promise for disease management of patients with congestive heart failure, hypertension (high blood pressure), and other conditions.
The Clinical Opportunity
There is a need for better tools to diagnose and manage heart disease. In the US alone, there are 5 million patients with CHF and over 50 million patients with hypertension.
Modern medications are complex and highly effective for […]
GE Buys E-Health Capabilities at Yard Sale Prices
Hardly anyone seems to have noticed, but General Electric has just completed its purchase of MedicaLogic (formerly Medscape), an eHealth medical record company.
“It’s a strategically important acquisition for us, said Greg Lucier, President and CEO of GE Medical Systems Information Technologies. “Our expansion into the ambulatory setting is a `first’ for GE, and because more patients experience care in this setting than any other in healthcare, it’s really an opportunity for us to make a major transformation in the healthcare […]
Adoption of E-Health Technologies – The Pace of a Turtle, The Intensity of a Steam Roller
“Taking the Pulse: Physicians and Emerging Information Technologies”
Deloitte Consulting, Deloitte & Touche; January 2002
Major Themes:
Time is Money. …the rate of adoption of information technology by practicing physicians is dependent on the relative impact on productivity and, by extension, on the economics of their practice.
Point of Care Information Technologies Remain Elusive (For Now).
Infrastructure Matters. …Value creation occurs when front-end applications and tools are integrated with robust backbone infrastructure–transaction systems and core databases.
Still Room to Master the Basics. …there is an abundance […]
Rewarding Physicians to Improve Quality of Chronic Care? What a Concept!!
Did you see the headline last week — “Six California Health Plans Formally Announce Quality Initiative”?
Eight million people are served by these six plans–Aetna, Blue Cross of California, Blue Shield of California, CIGNA Healthcare of California, Health Net, and PacifiCare. They have agreed to develop a common scorecard of quality measures and to pay physicians for achieving better scores.
Is the California initiative of Pay for Performance-Quality (PFP-Quality) a trend? Our commentary discusses four main points:
The PFP-Quality trend is here to […]
Mountains Beginning to Move? The Medicare Chronic Care Improvement ACt of 2001
One of the greatest barriers to delivering coordinated chronic care — perhaps THE greatest barrier — has been the lack of appropriate reimbursement.
With support from the National Chronic Care Consortium (NCCC) and the Chronic Care Coalition, Congressman Pete Stark and Senator Jay Rockefeller have introduced The Medicare Chronic Care Improvement Act of 2001. This legislation is designed to update and improve the Medicare health delivery system to meet better the needs of people with chronic health conditions.
The Institute of Medicine’s […]
Online Health Jeopardy
Are you familiar with the TV quiz show “Jeopardy” — the one where contestants are shown an answer and then have to come up with the right question?
Here’s today’s answer:
This recent government sponsored report makes recommendations in the following areas of online health:
Better management of clinical information to support care
Increased availability of online health services to provide direct clinical care
Increased use of online applications to support clinical practice
Facilitating the greater adoption of electronic commerce to produce a more efficient health […]
“Hospitals and Chronic Care Strategy: Stuck in the Middle”
Hospitals are an enigma when it comes to chronic disease management. While to-date most hospitals have watched from the sidelines, they have the POTENTIAL to become star players.
Key Questions for Hospitals to Consider
Are you in the chronic care business? Is it part of your mission to care for your patients’ ongoing chronic care needs? Are these questions even on your radar screen? If they’re not, they will be shortly.
How do Hospitals Fit into the Bigger Picture of Chronic Disease Management? […]
Patients Would Use E-mail to Communicate with Physicians
“E-mail Communications in Family Practice — What Do Patients Expect?”
The Journal of Family Practice, May 2001
Areas of Reported Interest Among Patients with E-mail Access
Communication with MD…… 89.9%
Request prescription refills… 86.7
Consult a nurse. …………….. 83.6
Obtain lab/test reports……… 81.2
Make/cancel appointments.. 77.6
Regardless of sex or race, patients have high expectations that these tasks can be completed within a relatively short time.
Pharmaceutical Trend Studies From Express Scripts
“2000 Drug Trend Report”
Express Scripts, June 2000
A 150-page report examining pharmaceutical utilization and spending trends.
The bottom line: Per […]
Five Critical Observations About Disease Management Assembling
“Build or buy?” is one of the most fundamental questions faced by any organization. A few years ago, it was unclear how this question should be answered in relation to chronic disease programs. The question is raised by a wide range of organizations involved in chronic disease management (DM) — including delivery systems, physicians, health plans, and DM support or outsourcing companies.
A third option — assembling — is making sense to an increasing number of organizations. Assembling is somewhere between […]
Gaining Physician Buy-In – The “Achilles Heel” of Disease Management
by Harry Leider MD, MBA
Why is achieving physician buy-in important to successful implementation of a disease management program?
It is my experience that programs that fail to gain widespread physician support have great difficulty enrolling patients and usually experience enrollment rates less than 40%. Conversely initiatives that enjoy strong physician sponsorship can achieve enrollment rates as high as 75%.
As a case in point, while I served as Medical Director of HealthNet (a regional managed care organization in Kansas City), we implemented […]
Health Plans and Physicians Agree on Clinical Guidelines – Minnesota Sets Standards for Best Practices!
Minnesota is becoming the first state in the nation where medical care is built around the systematic use of science-based best medical practice protocols developed by physicians and supported by major health plans. Collaboration, not competition, is the goal of Minnesota’s leading medical groups and health plans when it comes to quality health care.
Click here to read details about clinical improvements methods developed by the Institute for Clinical Systems Improvement (ICSI). An article in the New York Times further describes […]
IOM Report: Chronic Disease Management and E-Care Are Key Strategies to Improve U.S. Health Care Quality
“An elephant in the living room” is often used as a metaphor of what it’s like to live in a home with alcoholism — everyone knows it’s there, but no one talks about it. Admitting there is an elephant is a first step toward recovery.
Last week the Institute of Medicine (IOM) described the elephant in the living room of the U.S. health care system. The IOM issued a landmark report “Crossing the Quality Chasm: A New Health System for the […]
Next Generation Clinical and Business Models for Quality Driven Care Management
What’s All the Recent Commotion About Health Care Quality?
In the past several years, the issue of health care quality has received a great amount of press. Most of the news has focused on negatives — medical errors and patient safety issues that jeopardize lives.
Numerous studies have critiqued quality in the US health care system. For example, a report from the Institute of Medicine (IOM) — “To Err is Human: Building a Safer Health System” — was released in November 1999. […]
Emerging Themes: Physicians and the Internet
In the past several months numerous studies and analyses have examined physician adoption of Internet technology and tools.
With a dash of perspective tossed in, this essay synthesizes some major findings, conclusions, and wisdom from recent research.
1) Read the Fine Print – Studies Differ About Current Measurements of Physician Adoption of the Internet
How many physicians are online? 37%? 98%? ….somewhere in between? Whatever answer you pick, you will find “scientific” evidence supporting your guestimate in this provoking article in American Medical […]
The Cure is in Hand: Bringing Information Technology to Patient Care
Josh Fisher and Rosemary Wang of W.R. Hambrecht have issued a comprehensive 78 page report examining the wireless handheld market for physicians.
Here are a few highlights:
With less than 1% of U.S. physicians using handheld devices for transactional purposes today, we believe there are exceptional opportunities for companies developing handheld applications for the healthcare market.
We believe wireless handheld devices, which fit seamlessly into a physician’s workflow, will not only involve physicians but get them addicted to Internet technologies.
Already, approximately 15% of […]
E-Clinical Trials: A Boost for Disease Management Options
Two excellent recent studies provide in-depth and up-to-the-minute analyses of advancements in clinical trials. E-clinical trials promise to be a killer application of the Internet in health care.
Clinical trials research is a key aspect of improving disease management processes:
Clinical trials are a required step in taking promising pharmaceutical products and demonstrating their safety and efficacy.
Pharmaceutical products often can provide improved health and quality of life for patients.
Pharmaceutical products often (not always) are cost effective tools for disease management. Treating patients […]
Next Steps Taken in Medicare Coordinated Care Demonstration
Medicare is testing the cost-effectiveness of paying for case management and disease management (DM) services. The latest announcement from the Medicare Coordinated Care Demonstration describes plans to select at least eight demonstration projects by early 2001.
The demonstration is designed to:
Test proven models of coordinated care to improve the quality of services furnished to specific beneficiaries and manage expenditures under Parts A and B of the Medicare program;
Examine a variety of delivery and payment models applicable to the original Medicare fee-for-service […]
A First Look at Disease Management Under Defined Contribution
Just when you think all the acronyms in health care have been used up, along comes a new one. This one, however, is worth paying attention to. Defined Contribution (DC) promises to be as strong a force in the 00s as was managed care in the 80s and 90s.
What are Defined Contribution (DC) Health Benefits?
DefinedCare.com provides the following basic explanation of DC: Medical benefit defined contributions involve employers and other traditional purchasers of care providing an allowance, that empowers consumers […]
“E-Care: Internet Solutions Changing the Paradigms of Health”
Senior Analyst James Ackerman of Friedman, Billings, Ramsey & Co. has authored an excellent analysis of emerging e-care opportunities, a full 34 page report (dated June 1, 2000) and a 2 page summary.
The analysis includes discussion of
wireless, handheld physician automation tools,
home-based patient monitoring/disease management and
medical risk management by payors. A few highlights from the summary:
There are four key factors driving the widespread penetration of the Internet in healthcare. These include:
Spiraling costs and the imperative to find operating efficiencies.
Growth of healthcare […]
A Primer on Disease Management Terminology – is DM Like a Wall, a Spear, a Rope?
Remember the story about the blind men and the elephant? The first felt the side of the elephant and said it is “very like a wall”. The second touched the tusk and declared it is “very like a spear.” Another man held the elephant’s swinging tail and said it is “very like a rope.” And so on….
This is not unlike how people use the term “disease management” (DM). The meaning of the term DM depends very much on your knowledge […]
Lessons from History: Anticipating Implementation Challenges for eDM Programs
In the mid-1990s disease management (DM) outsourcing companies attempted to integrate their services into local delivery systems. They often encountered resistance from local providers (physicians and hospitals), who viewed the DM companies as outsiders.
Today a new wave of companies is beginning to develop Internet disease management (eDM) offerings. The challenge is similar: implementing and integrating eDM offerings into local delivery systems, which are often resistant to innovations of outsiders.
This essay will list and briefly describe some of the challenges experienced […]
An eDM Scorecard: Who’s Suiting up to Play in the Game?
A host of different organizations — some old, some new — are emerging from the wings to provide disease/care management services and tools utilizing the Internet!
…and they are approaching the Internet disease management (eDM) opportunity from very different angles.
Let’s categorize organizations scrutinizing eDM into four broad groupings:
Traditional Health Organizations
E-Health Companies: Business-to-Consumer (B2C)
E-Health Companies: Business-to-Business (B2B)
Other Technology Companies
How might each of these groups view the eDM opportunity?
Traditional Health Organizations
Traditional health organizations that have shown interest in eDM include DM outsourcing companies, […]
RWJF Report Forecasts Health Care in the U.S. Through 2010
A report entitled “Health and Health Care 2010” has been released by the Robert Wood Johnson Foundation and the Institute for the Future.
Here are a few summary findings from the section of the Executive Summary entitled “Care Processes and Medical Management”:
Medical management — the active management of the care of patients and populations — is currently applied sporadically, if at all. There are two main issues in the future of medical management. The first is the debate over which care […]
Healtheon/WebMD to Acquire Care Insite and Medical Manager – Good News for Advancing Care Management
The Richter scale shook again this week as Healtheon/WebMD announced an acquisition of CareInsite and Medical Manager. This mega-merger will bring together the #1 and #2 companies providing e-health connectivity. Details of the proposed deal can be reviewed at:
Healtheon to Buy Medical Manager
Healtheon-WebMD to CareInsite: “Be Mine!”
Online Health Firms Unite
Healtheon-WebMD Pops a Big Question
So what does the new HealtheonWebMD mean for those of us interested in disease management, care management, and clinical integration approaches?
Mostly it’s very good news.
Why? It avoids […]
“e-Care” Emerges as a Distinct Internet-Health Category
Internet health analysts initially divided the world of e-health into 3 or 4 “Cs” – usually Content, Connectivity, and Commerce (and sometimes Community).
Wit Capital has recently another C to the list –- Clinical Care.
Wit’s excellent 58 page report “eHealth 2000: Healthcare and the Internet in the New Millennium” can be viewed in either HTML or Adobe Acrobat formats.
Wit Capital’s report identifies this new category as — Clinical Care: The Convergence of Disease Management, Health Management and the Internet.
“Relentlessly rising healthcare […]
Five Simple Truths About Employers and Disease Management
Employers are playing an increasingly active role in disease management (DM) initiatives for their employees. Employers are recognizing that a disproportionate amount of health costs are incurred by a small percentage of their employees (typically 5% of a group accounts for about 60% of health care costs). Many employers are frustrated by perceptions that health care premiums are rising faster than medical costs and that health plans and providers are not taking enough steps to manage clinical care.
Here are 5 […]
Will the Internet Connect – or Disconnect – Patients and Physicians?
It’s hardly news these days, but there’s another entrant into the Internet health portal race. However, this one brings some unique twists. Medem has opportunities to employ both push and pull strategies to promote its web site and to improve the patient-physician relationship.
Wall Street and Main Street Health Care
At the new millennium, U.S. health care is living in two different worlds.
The world of Wall Street recognizes the huge opportunities in bringing the Internet to health care. In 1999, market capitalization […]
B2B eDM: Revolutionary Opportunities!
“What’s B2B eDM?” you ask. It stands for business-to-business Internet disease management.
The Internet is receiving great attention for its potential to improve disease management processes. However, almost all the attention has been paid to business-to-consumer (B2C) applications, rather than business-to-business (B2B) applications.
This parallels the attention that all B2C Internet companies have received over the past several years. The explosive potential of the B2B Internet market is just emerging!
This article highlights some of the strategic opportunities relating to B2B eDM. In […]
United Healthcare Pulls MBAs Licenses to Practice Medicine
In a story making national headlines this week, UnitedHealthcare (UHC) has announced that it is giving doctors the final say on treatments for their patients.
Good Medicine and Good Business
It’s hard to overstate the significance of UHC’s move. This is a sentinel event in the shift from managing cost to managing care!
It’s the right thing to do AND will prove to be an excellent business decision.
It’s another sign of the ending of the era of “MBAs Practicing Medicine”.
UHC’s Care Coordinator Program
United […]
Finally! Three e-Health Companies Focusing on Clinical Management Preparing to go Public!
A first wave of e-health companies went public earlier this year. These e-health companies focus primarily on 1) Automating back-office transactions (Healtheon, CareInsite, Claimsnet.com) or 2) Patient and/or physician content (DrKoop.com, adam.com, Mediconsult.com, Medscape).
We’re gratified to see funding ready to flow to companies focusing on care management opportunities. Within about the past two months, three care management companies have filed S1 statements with the Securities and Exchange Commission, a required step in taking a company public. The companies (and citations […]
Accordant Health: A Prototype for Clicks and Mortar Disease Management
Explaining “Clicks and Mortar”
David Pottruck, the co-CEO of Charles Schwab, recently coined the phrase “clicks and mortar” to describe the formula for success in the new economy. An article by Jonathan Weber in the Industry Standard describes the essence of this new catchphrase:
“the basic concept…is that the most successful businesses of this remarkable era will combine the power of the Internet with the ability to operate effectively in the offline world.”
Pottruck uses the brokerage company Charles Schwab as his prime […]
What’s Up with ASPs?
Application service providers, or ASPs, was one of the hottest topics under discussion last week at the Microsoft Healthcare Users Group Conference in San Diego. In this article, we will briefly describe ASPs, explain why they will be important, and list some specific implications for care management approaches. While ASPs will be attractive to all health care organizations, we will focus on the unique advantages they can provide for physician offices.
Not a Poisonous Snake, But a Great Concept
ASPs are a […]
Care Management on the Internet: If We Build It, Will They Come?
There are two sides to being a pioneer. Some pioneers come back with stories about lands of milk and honey. Other pioneers come back with bullet holes in their hats, or they don’t come back at all.
Health care organizations can learn from Internet pioneers in other fields. In this issue, we will take a look at two types of Internet financial services applications.
Online Banking – Not a Field of Dreams
First, let’s take a look at folks with holes in their […]
Summer Vacation Issue
Care Management – Big Picture Perspectives
Here’s an excerpt from a recent (July 27) investment analyst report on Internet health opportunities. “The EVolution of Healthcare” is published by EOffering, the investment bank arm of E*Trade. You can download the full report, “The Next Generation of Managed Care–Clinical Management
“After nearly a decade of managed care and its emphasis on cost containment, we believe that the ‘low-hanging fruit’ has already been picked from the healthcare system and that HMOs will now need to […]
All Bets Are On: Physicians are Using and Accepting the Internet!
The early returns suggest that physicians are adopting Internet technologies! In this issue of our e-newsletter, we share results of early surveys, explain why we expect these trends to continue, and discuss implications for care management.
Survey Results
Three separate surveys show more doctors use and accept the Internet.
PSL Research led a study conducted in Spring/Summer 1998. Key findings about physicians across the world include:
80% of physicians across eleven North American, European, and Asian countries own a computer and 44% of these […]
The FedEx Truck Phenomenon: The Need for a Strong Care Management Value Chain
Health care organizations can learn a valuable lesson by understanding how a “value chain” applies to care management approaches. Implementing the best care management approaches will require a mindset and culture that understands and embraces the value chain process.
Most of our e-newsletter readers (currently about 1,100) have roots in clinical care, business or technology. The value chain concept is understood better in the business and tech worlds, and there’s no reason it can’t be understood by everyone in healthcare.
So what’s […]
Patient-Centered Care: Motherhood and Apple Pie?
Seventy percent of health care costs in the U.S. are spent on people who have one or more chronic condition. The Robert Wood Johnson Foundation’s “Chronic Care in America: A 21st Century Challenge” is a classic study that details the clinical and financial issues involved.
A new term in the vocabulary of health care and managed care is “patient-centered” care. In short, it refers to care focused on the needs and preferences of an individual patient (more below). Patient-centered care for […]
Physicians and Care Management: MBAs Practicing Medicine, or Doctors Controlling Their Own Destiny?
Nearly 7 out of 10 physicians consider themselves “anti-managed care”, according to a recent study.
Physicians tend to equate the old model of managed care (managing costs rather than managing patient care) with overpaid MBAs who tell them how to practice medicine, squeeze them for discounts, and randomly throw them out of provider networks.
How do physicians feel about new approaches of care management? Shouldn’t they be wildly supportive? Studies are mounting that disease management, medical management, demand management, and case management […]
Healtheon: Establishing a Beachhead for Care Management
Summary:
Healtheon is a company to put on your radar screen. Its Internet business model is easily adaptable for future care management applications (disease management, demand management, case management, population health). Depending on your organization’s role in care management, Healtheon might soon be your vendor, competitor or partner.
Background: Healtheon and Its Internet Business Model
The Internet promises two transformational improvements for healthcare applications:
transactions processing
communications (among providers, between providers and patients, and patient access to medical information)
Healtheon’s initial value proposition focuses on improved […]