Home  >  Analytics   >   AHIP – The Usual Stories, Amidst Some Refreshing Perspectives

AHIP – The Usual Stories, Amidst Some Refreshing Perspectives

by Janice Young | June 29, 2016

collab-darwinAHIP 2016 is Las Vegas included the usual standard AHIP story lines. Better industry collaboration requires better partnerships, the promise of consumer engagement, the importance of harnessing data to better inform decision making and outcomes. Telemedicine was touted as a life-saving technology to industry cost and access challenges.

But, the absence of an all-encompassing regulatory issue has shaken the industry loose to reveal some new highlights and surprises

Seniors take center stage:  The millennial focus is tempered by a new strategic focus on the senior population, in particular the challenges and expenses of managing end of life care and care settings. As one who worked through a wrenching end of life care scenario with a parent just last year, this is a welcomed focus. Coincidentally, the AHIP discussions came on the heels of research released by Health Affairs identifying four unique spending patterns among senior populations in the last year of life – important research as the industry too frequently ignores critical variables among populations.

Interest in social factors expands:  As we all know, most of the success of a healthcare treatment occurs outside the physical office. Will the patient adhere to medication directions; keep the follow-up appointment; track and report blood sugar levels. We also know that social and environment factors play a key role in compliance.  The healthcare industry and technology partners have been flirting with integrating social factors into consumer health and behavior algorithms, both to better identify population requirements and extend social and support services to improve treatment outcomes. 2016 is the year of the social factor test cases and case studies. Targets are senior and chronic disease populations.

This issue was covered in-depth in our latest Insight Report on Total Active Risk.

Beyond the EHR and PHR:  Interestingly for a health plan conference, discussions highlighted the absence of EHR and PHR value – lack of a common longitudinal health record, gaps, multiple records for single individuals across multiple provider and provider systems, etc. Now that we’ve implemented the EHR and PHR, both provider and consumers are drowning in fragmented information they neither can use to effectively manage care.

Next generation recommendations called for shifting the focus from information storage (the EHR/PHR) to getting only the requisite information to the point of care for making a decision and delivering it to any device and platform. Next generation solutions include workflow, context, analytic or event triggered interactions that reduce a full electronic file of information down to three items of importance to a particular interaction or event.

The Old Guard Doesn’t Work: New Companies on the Block:  As in all evolutionary markets, new business challengers appear. Payer/provider joint venture companies shared opportunities and successes with joint ventures that promoted financial, technology and outcomes alignment. These companies, including ElevateHealth and Bright Health have the latitude to break the mold of traditional payer/provider relationships, leverage IT, co-mingling data and creating new care delivery models.

Iora, a brick and mortar, primary care organization has reset the primary care model to focus on prevention, provide health coaches, communicate with patients on preferred platforms, including text – all to improve primary care, health and outcomes.

In many ways, AHIP 2016 revealed the tension of the old guard and old legacy market strategies and the younger, more nimble individuals and organizations willing to point out that it doesn’t have to be that hard and also willing to invest in new business. The good news is the absence of IT and data no longer is the barrier it once was. The bad news is that legacy businesses can be slow to progress.

Anyone that has tried to work through end of life issues with a senior parent though may take heart. The experience of reconciling pages of hospital claims, dealing with fragmented care settings and processes along with associated health information scattered across these settings is not a pleasant experience. One can only hope that the new found focus on the issue of effectively addressing senior healthcare issues by new entrants will create a spark that is so long overdue.

Leave a Reply

Your email address will not be published. Required fields are marked *

Stay up to the minute.