Technology, quality, transparency, incentives and engagement. In order to cure healthcare and achieve a merit-based system, all of these things needs to coexist in the healthcare ecosystem. How can we build a platform that pulls all of them together? A panel of experts discussed this very notion at Castlight Health’s inaugural Enterprise Healthcare Summit on June 10, 2014, in New York City.
When moderator Paul Mango, director at McKinsey & Company, asked panelists what is being done well and what can be done better across the industry, Toby Cosgrove, MD, CEO and president of the Cleveland Clinic, noted that “probably the most important thing about being transparent about quality isn’t the quality itself, but about looking in the mirror,” speaking to the notion that quality metrics are as much about providing information to consumers as it is about giving providers, payers, employers and other solutions providers the information they need to improve.
Ken Goulet, president of commercial and specialty business for WellPoint, mentioned that “being the largest carrier, we have a responsibility” — one that they are taking very seriously, with WellPoint also being “the largest carrier in terms of pay for performance.” But Goulet recognized the power of collaboration around increasing data availability to consumers, adding that “we provide transparency, but when we saw that our friends at Castlight can do a better job, we opened ourselves up to that.”
Shawn Leavitt, senior vice president of global benefits for Comcast, discussed the importance behind data being actionable. “We’ve heard a lot today about this brave new world of information for consumers. But the big question is, ‘what do you do with it?’”
Tara Montgomery, senior director for Health Impact at Consumer Reports, talked about the human element in fixing the broken healthcare system. “It’s all about relationships and [Consumer Reports’] role in that. You can’t just throw one type of tool at everybody and say ‘good luck, you now have transparency’.” Montgomery continued to say that “there’s a step [in consumer engagement] that isn’t about technology, but the technology is the catalyst.”
When asked what innovations he’s seeing a demand for in the market, Jim Winkler, senior vice president and chief innovation officer at Aon Hewitt, commented on the need to separate innovation around insurance and innovation around cost. He also brought up the “misalignment between how we pay for care and how care is delivered,” citing the “notion that one person’s cost savings is another person’s income adjustment. Thirty million Americans derive their salary from the healthcare system, so it’s easy to talk about innovation and cost savings, but you have to think about what that means for other who are losing out.”
In terms of promoting efficiency in the system, the need for telehealth and mobile health expansion was discussed. “We need technology that gets care into the home,” said Leavitt. “Whether it’s two way cameras, through post-op care, or part of a care plan, we need those touch points.” In terms of mobile health, Leavitt is “a believer that 75% of us will wear a device 24×7 that monitors everything we do.”
The role of personalized benefits design was also an important topic for discussion. From the perspective of Consumer Reports, Montgomery says that “it’s all about relationships and our role in that. You can’t just throw one type of tool at everybody and say ‘good luck, you now have transparency’.” She also noted that “there’s a step [in consumer engagement] that isn’t about technology, but the technology is the catalyst.”
In looking at the role that benefits design plays in advancing a merit based healthcare system, Leavitt spoke to the process. “Should the design be around the process? Is it more effective for people to go through the decision making process to decide what works best for them?”, he asked. “Should we have a special selection process that people go through that helps them select the right provider from a quality perspective?”, he continued.
As far as defining what, exactly, quality is, well, that’s still up for discussion. “There’s really not an understanding of what quality is,” said Leavitt. Others agreed. “Understanding quality is a very complex thing,” said Cosgrove. “It depends on what you do and the metrics are a lot more complicated than just measuring cost.”
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