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Why Do People Think Adherence Is So Easy?

May 6, 2013 by George Van Antwerp 2 Comments

I think we all know that medication adherence is a big deal. The most common number quoted is the $290B waste number from NEHI. There are numerous studies that confirm the value of non-adherence even one that just came out.

The amount of money spent on trying to improve adherence is huge! Pharma has worked on. Retail pharmacies have worked on it. Providers have worked on it. Insurance companies have worked on it. Employers have worked on it… And all of these have happened across the world.

At the same time, you see people get so excited about things don’t make any sense to me.

Let me take an easy example. A few months ago, a company called MediSafe put out a press release around moving medication adherence on statins up to 84.25%. Nothing against the company, but I read the press release and reached out to them to say “this is great, but it’s only 2 months of data…most people drop therapy after the first few months so who care…call me back when you get some good 12 month data.”

But, a lot of people got all excited and there was numerous press about this – see list of articles about them.

Now, tonight, I see another technology getting similar excitement. Fast Company talks about the AdhereTech technology which integrates a cellular phone with a pill bottle. And, it costs $60 a month. In my experience, companies wouldn’t even spend $2 a month to promote adherence so $60 is just impractical. The argument is that this is good for high cost specialty drugs that are oral solids not injectables. But, this isn’t a new idea. Glowcaps already built this model with a very slick interface and workflow.

And, I don’t know about you, but I think this would be obnoxious. And, I love data and am part of the QuantifiedSelf movement. I’m not sure I understand the consumer research here. I would have to believe all of the following to buy into this model.

  • Non-adherence people are primarily not adherent due to no reminders to take their medication on a daily basis.
  • People with chronic conditions that require high cost specialty drugs are going to change behavior because some bottle sends them a text message.
  • Manufacturers or some other healthcare company is willing to pay $60 a month for this service.
  • There won’t be message fatigue after a few months (weeks) of messaging.
  • Pharmacies would be have to be willing to change their workflow to use these bottles.

Yes. Will this work for some people…sure. But, if it helps 10% of people, then my cost is really $600 per success.

Should we be working on better solutions to address adherence…of course.

But, let’s stop trying to figure out some gimmick to fix adherence. Let’s look at root cause.

For example:

  • People don’t know why they’ve been given a medication.
  • People don’t understand their disease.
  • People can’t afford their medication.
  • People don’t know what to expect in terms of side effects.
  • People don’t see value in improving adherence.
  • People don’t know they have to refill their medications.
  • People aren’t health literate.

We have a lot of problems.

Books / Articles, Healthcare, Managed Care, Marketing / Communications, Methodology, mHealth, PBM / Pharmacy, Research, Value Propositions
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How Walgreens Became One Of The More Innovative Healthcare Companies

April 28, 2013 by George Van Antwerp 1 Comment

While we are generally a society focused on innovation from start-ups (and now all the incubators like Rock Health), there are a few big companies that are able to innovate while growing.  That’s not always easy and companies often need some catalyst to make this happen.  Right now, there are four established healthcare companies that I’m watching closely to track their innovation – Kaiser, United/Optum, Aetna, and Walgreens.  (Walgreens has made the Fast Company innovation list 3 of the past 4 years.)

I think Walgreens is really interesting, and they did have a great catalyst to force them to really dig deep to think about how do we survive in a big PBM world.  It seems like the answer has been to become a healthcare company not just a pharmacy (as they say “at the corner of Happy and Healthy”) while simultaneously continuing to grow in the specialty pharmacy and store area.

Let’s look at some of the changes they’ve made over the past 5 years.  Looking back, I would have described them as an organic growth company with a “not-invented-here” attitude.  Now, I think they have leapfrogged the marketplace to become a model for innovation.

  1. They sold their PBM.
  2. They re-designed their stores.
  3. They got the pharmacist out talking to people.
  4. They got more involved with medication therapy management.
  5. They increased their focus on immunizations increasing the pharmacists role.
  6. They formed an innovation team.
  7. They invested heavily in digital and drove out several mobile solutions including innovations like using the QR code and scanning technology to order refills.
  8. They’ve reached out to partner with companies like Johns Hopkins and the Joslin Diabetes Centers.
  9. They increased their focus on publications out of their research group to showcase what they could do.
  10. They started looking at the role the pharmacy could play and the medications played in readmissions.
  11. They partnered with Boots to become a much more global company.
  12. They offered daily testing for key numbers people should know like A1c and blood pressure even at stores without a clinic.
  13. They created an incentive program and opened it up to link to devices like FitBit.
  14. They partnered with The Biggest Loser.
  15. They increased their focus on the employer including getting into the on-site clinic space.
  16. They created 3 Accountable Care Organizations.
  17. They partnered with Novartis to get into the clinical trials space.
  18. They developed APIs to open their system up to developers and other health IT companies.
  19. They formed a big collaboration with AmerisourceBergen which if you read the quote from Greg Wasson isn’t just about supply chain.

    “Today’s announcement marks another step forward in establishing an unprecedented and efficient global pharmacy-led, health and wellbeing network, and achieving our vision of becoming the first choice in health and daily living for everyone in America and beyond,” said Gregory Wasson, President and Chief Executive Officer of Walgreens. “We are excited to be expanding our existing relationship with AmerisourceBergen to a 10-year strategic long-term contract, representing another transformational step in the pharmaceutical supply chain. We believe this relationship will create a wide range of opportunities and innovations in the rapidly changing U.S. and global health care environment that we expect will benefit all of our stakeholders.”

  20. They jumped into the retail clinic space and have continued to grow that footprint physically and around the services they offer with the latest jump being to really address the access issue and help with chronic conditions not just acute problems.

“With this service expansion, Take Care Clinics now provide the most comprehensive service offering within the retail clinic industry, and can play an even more valuable role in helping patients get, stay and live well,” said Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions, Walgreens. “Through greater access to services and a broader focus on disease prevention and chronic condition management, our clinics can connect and work with physicians and other providers to better help support the increasing demands on our health care system today.” (from Press Release)

This is something for the whole pharmacy (PBM, pharma, retail, mail, specialty) industry to watch and model as I talked about in my PBMI presentation (which I’m giving again tomorrow in Chicago).  It reminds me of some of the discussions by pharma leaders about the need to go “beyond the pill”.

 

Books / Articles, Care Management, Consumerism, exercise, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, mHealth, PBM / Pharmacy, Press, Technology, Value Propositions
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How Aetna’s Pivoting With Healthagen – #whcc13

April 9, 2013 by George Van Antwerp 0 Comments

Do you know the term “pivot“? It’s all the rage now in terms of describing how companies continue to evolve their models with this rapidly changing business environment.

Of course, Aetna is one of the big healthcare players in the US. They’re not going to abandon a model that’s been working for well over 100 years. But, thanks to some great leadership from people like Mark Bertolini, CEO of Aetna, they’ve created a new business unit called Healthagen (building on the company they bought known mostly for iTriage). The screen shot says it all.

I got the privilege to sit down with Dr. Charles Saunders who runs Healthagen at the World Healthcare Congress in DC (#whcc13).

Charles E. Saunders, M.D., is responsible for leading the strategic diversification of Healthagen’s products, services and global opportunities. He focuses on identifying new growth opportunities and developing market strategies that can help Healthagen and Aetna profitably manage quality and cost for its customers.

Prior to joining Healthagen, Dr. Saunders served as executive in residence at Warburg Pincus, one of the world’s largest and oldest private equity firms. He has held a number of other significant leadership positions during his career, including CEO of Broadlane, Inc., President of EDS Healthcare Global Industry Solutions; Chief Medical Officer of Healtheon / WebMD; Principal of A.T. Kearney; and Executive Director of San Francisco General Hospital Managed Care Programs.

Dr. Saunders received a B.S. in biological sciences from the University of Southern California and an M.D. from Johns Hopkins University. He is board certified in Internal Medicine and Emergency Medicine and has served on the faculty of several universities, including the University of California, San Francisco; Vanderbilt University; and University of Colorado.

I also got to hear him speak right before I talked to him. (As a side note, he is a great presenter which is something that I really respect in a world of people who present too many slides, use notes, talk to the screen, and can lose you quickly.)

He hit on several key themes in his presentation that we then discussed further face-to-face:

  1. Social Caregiver Model
  2. Game Theory
  3. Digital / Mobile

One of my first questions was to really understand Healthagen and what it was set up to do. (As you can see from the screen shot below, they’re doing lots of things in this group.)

He boiled it down nicely to three things:

  1. Physician (provider) enablement
  2. Patient engagement
  3. Population Health Management IT

Our next discussion was really around why and how to create and innovate within a large company like Aetna. He reiterated what I believed that Mark Bertolini championed this new vision along with several of the other senior leaders. But, I think the key was that they recognized that issue of trying to do that internally and were willing to form a group to be different. To minimize bureaucracy for this group. And, to leverage their capital and assets to support this group. Not many big companies do this well. My impression is that Aetna is and will continue to be successful here. (Full disclosure – I own a minor number of Aetna shares and have believed this since I bought them about a year ago.)

Of course, in today’s market, there’s an explosion of innovation with questions on the short-term and long-term ROI of many initiatives and start-ups. With that in mind, Dr. Saunders pointed out that they don’t want to own everything. They want to create a plug and play platform of enablement. iTriage is a great example of this where they brought in a mobile technology with 2M downloads in 2011 and now have over 9.5M downloads of the tool (on top of massive increases in functionality and integration). You can download it here – https://itunes.apple.com/app/itriage-health-doctor-symptoms/id304696939?mt=8.

Certainly, one concern others have historically had in this space was how to own solutions and sell them to their peers (competitors). Dr. Saunders talked about their ability to do this with ActiveHealth and a perception that the industry is over that issue as long as Aetna can continue to demonstrate that they are good stewards of the data and are keeping the appropriate firewalls in place.

We wrapped up the conversation talking about the social caregiver and game theory. I think both are important in our mHealth / digital world. With the sandwhich generation, this is increasingly important. That is where Aetna is focusing…enablement of the caregiver for infants and seniors leveraging a social approach. This reminds me of their recent announcement of a pilot with PatientsLikeMe. We also talked about game theory and the role of that in healthcare which is a common theme from my discussion with Keas this morning and a theme from the overall conference.

It should be interesting to watch Dr. Saunders and his team and how Aetna continues to pivot.

Consumerism, Events, Healthcare, Leadership, Managed Care, Marketing / Communications, Methodology, mHealth, Press, Technology, Value Propositions
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Key Topics At #WHCC13 In DC

April 9, 2013 by George Van Antwerp 0 Comments

I’m at the World Healthcare Congress (WHCC13) in Washington DC this week.  This has always been one of the top 5 events for me to try to come to every year (admitting that there are a few like TED that I haven’t attended due to budget yet).

It’s interesting  how trends start to flow within a conference and how the trends change year to year.  This year, the key themes that I continue to hear are (in no order):

  • Engagement is critical.  Between MD and Patient.  Between social network / influencers and member.  Between employee and employer.
  • We have to get past the barriers to health enablement (i.e., legacy IT systems) and make change happen.
  • Game theory can help improve engagement.
  • Mobile tools are important.
  • Data integration has to happen and employers are doing it themselves.
  • Biometrics are critical path.
  • We can’t solve healthcare if we don’t solve health.  The community.  Our food choices.  Work / life balance.  (I would add sleep and stress.)
  • Rapid innovation.
  • Reform isn’t going to be easy on the employer or the employee.

But, since Twitter is my new note taker…here’s a few sets of tweets for you.

#whcc13 tweets whcc13 tweets3 whcc13 tweets2 whcc13 tweets1

Events, Healthcare, Managed Care, Marketing / Communications, mHealth, Press
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How The CVS Program Will Change The Employer – Employee Contract

March 22, 2013 by George Van Antwerp 1 Comment

Have you heard that CVS Caremark is requiring employees to go get biometrics and going to take action on it? OMG!

I’m not sure I understand why people are all upset. Let’s look at the facts:

And, by the way, have we forgotten how much healthcare costs have gone up over time and who pays that bill. It’s either the employer or the government. Both of those things impact our pay as individuals either in terms of lower raises to cover healthcare costs, shifting healthcare costs to us, or taxes. It’s not sustainable so the person who pays the bill has to step in since we’re not. (Which is also why I support the NY ban on soda.)

Now, let’s look at our healthcare system where in the current fee-for-service model, there isn’t an incentive for physicians to address this.

For now, people should be happy. They’re only being required to do the biometrics. The penalty isn’t linked to whether they’re fat or have high blood pressure or smoke or have high cholesterol or have diabetes. A recent study by Towers Watson shows that while 16% of employers do this type of outcome based incentive program today (2013) that this is going to jump to 47% in 2014. So, this will be the norm.

And, guess what…sticks often work better than carrots in some cases.

And, healthcare costs are making us uncompetitive globally as a country.

  • The cost of healthcare is greater than the cost of steel in a car.
  • The cost of healthcare is greater than the cost of coffee in a Starbuck’s cup of coffee.

And, health reform is allowing (even enabling) this to happen. It says that you can treat people differently and create up to a 50% differential in costs associated with their health. (Not a legal definition so read the fine print.)

But, what I think all of us (consumers and employers) will need to realize is that moving to this (which I agree with) will change the employer and employee relationship in several ways.

  1. You can’t put these programs in place without something to help me manage my obesity, cholesterol, and/or other chronic condition. This will drive wellness and disease management programs to be more engaging and successful.
  2. This will put pressure on employers to create a culture of health since we spend so much time at work and work contributes to our health conditions.
    1. Need more time to be active. Less sitting. Treadmill desks. Standing meetings. Nap time. Walking breaks. Use of devices to track steps. Incentives. Gym discounts. Healthy food discounts.
    2. Need less stress.
    3. Need more sleep.
    4. Better food choices at work.
  3. This will drive a lot of the new tools and run counter to some trends about limiting dependent coverage since you can’t address obesity without engaging the entire family and the social network.
  4. This will also create a whole exception process by which people who gain weight due to certain drugs have to be excluded. People who can’t exercise may have to be excluded. People may have to see short-term goals (i.e., dropping BMI from 35 to 32). Physicians will have to be engaged.
  5. Coaching will have to expand to include dieticians, social workers, and others to help people beyond the historical nurse centric coaching model.

If none of this motivates you, then just think about the “gift” we’re giving our kids and maybe that will be a wake-up call why someone has to do something here. (As I shared the other day, I struggle with my weight so don’t think I’m some super skinny, high metabolism person who thinks this is easy.)

Books / Articles, Business Tools, Care Management, exercise, Healthcare, Leadership, Managed Care, Marketing / Communications, Research, Value Propositions
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59% Of MDs Want To Know About Employer Care Mgmt Efforts

February 12, 2013 by George Van Antwerp 0 Comments

I just came across this survey data from January of 2010 where the Midwest Business Group on Health (MBGH) did a survey of physicians. I found it really interesting. Let me pull out a few points with some comments…

  • 72% of physicians agree that employers should have a role in improving and maintaining the health of their employees with chronic disease. [Since they ultimately are the one paying the bill, this seems like a reasonable expectation in today's world.]
  • 59% believe that they should be informed about employer efforts to help their patients manage chronic conditions. [This is increasingly becoming important as we move from a Fee-For-Service (FFS) world to a value-based or outcomes-based healthcare environment.]
  • 46% agree that employers should have a role in helping employees adhere to their medication and treatment regimes. [Since MDs generally don't view this as their task, if it's not someone acting on behalf of the employer, I wonder who they think should be doing this.]
  • 32% agree that employers should play no role in the health of patients. [With healthcare impacting productivity and global competitiveness, I think this is an unreasonable expectation.]
  • 61% want the employer to provide physicians with information on what is available to patients so they can counsel them on the value of participation. [How would they want this information and what would they do with it?]
  • 49% would like to receive workplace clinical screening results to reduce redundancies in testing. [Do the other 51% want duplicative testing?]
  • 48% want to receive actionable reports (e.g., screening results, health coaching reports) to support them in treating patients. [I would hope so. If the employer (or really their proxy) is managing the patient in a chronic program, why wouldn't the physician want this data?]
The study went on to say that physician’s want employers to provide support around weight loss, smoking cessation, flu shots, and other broad programs. They also want the employer to focus on lifestyle change and health improvement not the chronic disease itself. This makes sense, but in general employees are more focused on trusted information coming from their physician not their employer so there’s a clear gap here. (See graph from Aon Hewitt’s 2011 Health Care Survey, New Paths. New Approaches.)
Books / Articles, Care Management, Healthcare, Leadership, Managed Care, Marketing / Communications, Research, Technology
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Only 50% Of Healthcare Companies Respond To Twitter Messages – Test Results

February 11, 2013 by George Van Antwerp 1 Comment

12 Of 23 Companies

As I mentioned a few weeks ago (2/2/13), I wanted to test and see if healthcare companies would respond to consumers via Twitter. To test this, I posted a fairly general question or message on Twitter to see the response (see below). Of the 23 companies that I sent a message to, only 12 of them ever responded even after 6 of them received a 2nd message. Those results are shared below. What I also wanted to look at was the average time to respond along with which group was more likely to respond.

  • PBMs – All of the 3 PBMs that I reached out to responded. (This could be biased by my involvement in this space since two of them e-mailed me directly once I posted a comment.)
  • Pharmacies – Only 2 of the 4 retail pharmacies that I reached out to responded.
  • Disease Management Companies – Only 1 of the 3 that I reached out to responded. (I was surprised since Alere often thanks me for RT (re-tweeting) them, but didn’t respond to my inquiry.)
  • Managed Care – 5 of the 7 companies that I reached out to responded. (For Kaiser, they responded once I changed from @KPNewscenter to @KPThrive.)
  • Health Apps or Devices – Only 1 of the 5 companies that I reached out to responded. (This continues to surprise me. I’ve mentioned @FitBit on my blog and in Twitter numerous times without any response or comment.)
  • Pharmaceutical Manufacturers – Only 1 of the 3 companies that I reached out to responded. (This doesn’t surprise me since they are very careful about social media. @SanofiUS seems to be part of the team that has been pushing the envelope, and they were the ones to respond. I thought about Tweeting the brands thinking that those might be monitored more closely, but I didn’t.)

I will admit to being surprised. I’m sure all of these companies monitor social media so I’m not sure what leads to the lack of response. [I guess I could give them the out that I clearly indicated it was a test and provided a link to my blog so they could have chosen not to respond.]

Regardless, I learned several things:

  1. Some companies have a different Twitter handle for managing customer service.
    1. @ExpressRxHelp
    2. @AetnaHelp
    3. @KPMemberService
  2. Some companies ask you to e-mail them and provide an e-mail.
  3. Some companies tell you to DM (direct message) them to start a dialogue.

From a time perspective, I have to give kudos to the Prime Therapeutics team that responded in a record 2 minutes. Otherwise, here’s a breakout of the times by company with clusters in the first day and approximately 2 days later.

Company

Response Time (Hrs:Min)
Prime Therapeutics

0:02
Aetna

1:12
LoseIt

1:19
Healthways

2:07
Walmart

3:01
Express Scripts

8:35
Kaiser

29:22
BCBSIL

47:32
OptumRx

47:39
BCBSLA

48:18
Sanofi

53:30

I guess one could ask the question of whether to engage consumers via Twitter or simply use the channel more as a push messaging strategy. The reality is that consumers want to engage where they are, and there are a lot of people using Twitter. While it might not be the best way to have a personal discussion around PHI (Protected Health Information) given HIPAA, it certainly seems like a channel that you want to monitor and respond to. It gives you a way to route people to a particular phone number, e-mail, or support process.

As Dave Chase said in his Forbes article “Patient engagement is the blockbuster drug of the century”, this is critical for healthcare companies to figure out.

The CVS Caremark team told me that they actively monitor these channels and engage with people directly. I also talked with one of the people on the Express Scripts social monitoring team who told me that they primarily use social media to disseminate thought leadership and research, but that they actively try to engage with any member who has an actionable complaint. They want to be where the audience is and to quickly take the discussion offline.

If you want to see the questions I asked along with the responses, I’ve posted them below…

Consumerism, Healthcare, Managed Care, Marketing / Communications, Methodology, mHealth, PBM / Pharmacy, Research, Social Media, Technology
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The Prescribing Apps ERA – Will Clinicians Be Ready? #mHealth

February 7, 2013 by George Van Antwerp 1 Comment

Dr. Kraft (@daniel_kraft) recently spoke at FutureMed and talked about the prescribing apps era.  I’ve talked about this concept many times, and I agree that we are rapidly moving in that direction.  And, there’s lots of buzz about whether apps will change behavior and how soon we’ll see “clinical trials” or published data to prove this.

From this site, you can get a recap, but here are the key points that he made:

1) Mobile Phones (quantified self) are becoming constant monitoring devices that create feedback loops which help individuals lead a healthy lifestyle.  Examples include; monitoring glucose levels, blood pressure levels, stress levels, temperature, calories burned, heart rate, arrythmias. Gathering all this information can potentially help the patient make lifestyle changes to avoid a complication, decrease progression of a particular disease, and have quality information regarding his physical emotional state for their physician to tailor his treatment in a more efficient manner.

2) The App prescription ERA:  Just as we prescribe medications prescribing apps to patients will be the future. The reason why this is important is that apps created for particular cases can help the patients understand their disease better and empower them to take better control.

3) Gamification: using games in order to change lifestyle, habits, have been mentioned before. A very interesting concept was that created in the Hope Labs of Stanford. The labs created a game in which children would receive points after there therapeutic regiment, once points were optioned they could shoot and attack the tumor. Helping with the compliance rate of the treatments

4) Lab on a chip and point of care testing

5) Artificial Intelligence like Watson and its application in medicine.

6) Procedure Simulation: Several procedures done by medical professionals follow (not 100%) a see one, do one teach one scenario.  Probably very few people agree with this concept and that is why simulation has great potential. In this case residents, fellows in training can see one, simulate many and then when comfortable do one.

7) Social Networks and Augmented Reality

At the same time, a recent ePocrates study hammered home the point that while this is taking off physicians don’t have a mechanism for which ones to recommend and why.

According to the Epocrates survey, more than 40 percent of physicians are recommending apps to their patients. In terms of the apps being recommended, 72 percent are for patient education, 57 percent are lifestyle change tools, 37 percent are for drug information, 37 percent are for chronic disease management, 24 percent are for medical adherence and 11 percent are to connect the patient to an electronic health record portal.

Physicians also have several different sources for identifying which apps to recommend to their patients. According to the survey, 41 percent get advice from a friend or colleague, while 38 percent use an app store, another 38 percent use an Internet search engine, 23 percent learn of an app from another patient or patients, and 21 percent use the app themselves.

That said, the survey also notes that more than half of the physicians contacted said they don’t know which apps are “good to share.”

As I’ve discussed before, this is somewhat of the Wild West.  Patients are buying and downloading apps based on what they learn about.  They’d love for physicians, nurses, pharmacists, and other trusted sources to help them.  But, those clinicians are often not technology savvy (or at least many of the ones who are actively practicing).  There are exceptions to the norm and those are the ones in the news and speaking at conferences.

IMHO…consumers want to know the following:

  1. Which apps make sense for me based on my condition?
  2. Will that app be relevant as I move from newly diagnosed to maintenance?
  3. Should I pay for an app or stick with the free version?
  4. Is my data secure?
  5. Will this app allow me to share data with my caregiver or case manager?
  6. Will this app have an open API for integration with my other apps or devices?
  7. Is it intuitive to use?
  8. Will this company be around or will I be able to port my data to another app if the company goes away?
  9. Is the information clinically sound?
  10. Is the content consumer friendly?
  11. Is it easy to use?
  12. Is there an escalation path if I need help with clinical information?
  13. Will my employer or health plan pay for it for me?
  14. Is my data secure?

And, employers and payers also have lots of questions (on top of many of the ones above):

  1. Is this tool effective in changing behavior?
  2. Should I promote any apps to my members?
  3. Should I pay for the apps?
  4. How should I integrate them into my care system?
  5. Do my staff need to have them, use them, and be able to discuss them with the patient?  (Do they do that today with their member portal?)

mhealth_infographic_large

Books / Articles, Business Tools, Consumerism, Healthcare, Infographic, Innovation, Leadership, Managed Care, Marketing / Communications, mHealth, Research, Social Media, Software, Technology, Value Propositions
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How Quickly Do Healthcare Companies Respond To Twitter Comments? (Test)

February 2, 2013 by George Van Antwerp 0 Comments

I was intrigued by this test done over in the UK to look at how quickly retailers responded to comments via Twitter (you can see an infographic about similar US data below).  Obviously, more and more consumers are using social media.  And, we know that comments can go viral quickly especially when they’re negative.

“A recent Spherion Staffing Services survey shows that when consumers have a good customer service experience, 47 percent are likely to tell a company representative; 17 percent will express their opinions via social media; and 15 percent will write a review. The same survey from 2010 showed that only 40 percent of consumers were likely to share a great experience with a company representative—proving that consumers are becoming more vocal with companies they interact with. If consumers have a poor experience, 36 percent are willing to write a complaint directly to the company, and one in four will express their opinions on social media. Nineteen percent, the same statistic as last year, will choose to write a review online.” (December 2011 Study)

Of course, some people actively monitor their social media feeds while others view them more as a PR channel.  It also depends on whether the feed management is outsourced or insource and whether it’s monitored by marketing, operations, customer service, sales, or some combined team.

Here’s a good post on measuring response and activity within Twitter accounts.

So, what I’ve decided to do is a Twitter test similar to the one above.  I’m going to post the following to different categories of healthcare companies and see how quickly they respond.

  1. To retail pharmacies:  Are you using social media to handle customer service?
  2. To PBMs:  Are you using social media to handle customer service?
  3. To Managed Care: Where’s the best place to find out about your Medicare products?
  4. To mHealth companies:  Can you share examples of how employers are promoting your products?
  5. To pharma:  Are you doing any value-based contracting with PBMs?
  6. To device companies:  Can you share examples of how employers are promoting your products?

Who do you think will be the fastest to respond?  Will the bigger companies simply have more resources to monitor and staff their teams or with more digital companies be more in tune with social media?

KeepingUpWithTwitter_2

Books / Articles, Business Tools, Healthcare, Infographic, Managed Care, Marketing / Communications, mHealth, PBM / Pharmacy, Research, Social Media
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PHM Is The New Black Post At CCA Blog With Diabetes Examples

January 25, 2013 by George Van Antwerp 0 Comments

This is a partial copy (teaser) of a guest blog I did on the Care Continuum Alliance blog earlier this week.

**********************

With all the talk about Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs), the adoption curve for the Care Continuum Alliance (CCA) model for Population Health Management (PHM) should move beyond the innovators in 2013 and begin to “Cross the Chasm.” I believe there are several preconditions that would set the stage for this to occur, for instance:

  1. Technology advances leading to the “Big Data” focus;
  2. The changing paradigm from fee-for-service to outcomes-based care;
  3. The realization of the role of the consumer led by the e-Patient movement, the idea of the Quantified Self, and the focus of large healthcare enterprises on being consumer centric; and
  4. The budget crisis that is driving employers and other payers to embrace PHM, wellness, and other initiatives that impact cost and productivity.

Of course, most companies are still in the infancy of designing systems to address this coordinated care model, which does not view the patient as a claim, but longitudinally aggregates demographical, psychosocial and claims data.  Additionally, training staff using Motivational Interviewing and integrating external staff into the virtual care team in partnership with the provider will continue to evolve as do our care delivery models.

To read more especially the diabetes examples that I shared, please click over to their blog.  Thanks.

 

Books / Articles, Care Management, Guest Post, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, mHealth, Research, Value Propositions, Weblogs
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Infographic: ACO Activity Assessment

December 31, 2012 by George Van Antwerp 0 Comments

This is a nice infographic on some of the ACO activity around the country.

ACO_Activity_Infographic

Healthcare, Infographic, Managed Care, Research, Value Propositions
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Using Gilligan To Drive Colonoscopies

November 6, 2012 by George Van Antwerp 0 Comments

While I do applaud the creative concept here, I wasn’t overly impressed with the creative itself.  At the end of the day, the question for me is results.  Did it pay for itself?  Did it get more people to get colonoscopies (in the target audience) than otherwise would have?  I’m unsure of that.

Here’s what I did find in a HealthLeaders article…At the end of the day, I’d want to compare that to a program we did at my last company for UHG in this area.

The campaign also netted 44 colonoscopy appointments. Of those 44 appointments, 13 were current Good Samaritan patients and 31 were new to the hospital. Forty-three of the 44 scheduled an appointment through the call center and one booked online. Of those who called, 27 cited the radio spot as how they found out about the service. More than half of the patients were in the target group of 50–59 year olds, with 24 female and 20 male.

Care Management, Healthcare, Innovation, Managed Care, Marketing / Communications, Silverlink, Social Media

When Is It Good To Pay 300% Profit For A Medication?

August 2, 2012 by George Van Antwerp 0 Comments

Another interesting discussion at this Oncology event was about physician reimbursement for drugs.  In Oncology, one historical source of revenue (~50%) for physicians has been the medications they dispense and administer in their offices.  And, depending on who you believe, this has some degree of influence on what drugs they dispense.

The problem that was discussed is that today’s reimbursement model is ASP (Average Selling Price) plus 6% mark-up.  This assumes that everyone buys at some price near that average which by definition means that not everyone does.  One of the presenters suggested that physicians lose money on about 20-25% of the drugs they dispense and that it would need to be ASP + 12% for them to be positive on every drug.  (I don’t know the math here and am simply sharing the dialogue as I found it very intriguing.)

The examples that they kept talking about in several presentations were that for a generic drug that costs $40 then their margin is theoretically $2.40 (6%) versus for a brand drug that’s $4,000 where their margin is $240 (or 6%).  The suggestion was that if generics were reimbursed at 200-400% of ASP then it would take this economic factor out of the oncologists influence (when conscious or subconscious). 

It’s an interesting debate.  (Here’s some comments from another conference on this topic.)

On the flipside, some of this may go away with oral oncolytics being more common in the future (and therefore being more likely to be controlled by the PBM) although companies will look to enable in-office dispensing of these drugs also to help the physician from losing this income. 

The other strategy being pushed has been called “brown bagging” where the patient is directed to obtain their medications from a specific specialty pharmacy and then bring those to the oncology practice for them to use.  This eliminates the “buy-and-bill” approach but is not something that the physicians like (from what I know). 

At the end of the day, I don’t really care.  I think there are several key principles that if met would make me neutral to any solution:

  1. Are decisions made in the patient’s best interest or do financial implications impact clinical decisions?
  2. Is the safety of the patient impacted in any way?
  3. Is the patient experience impacted negatively in any way?
Healthcare, Managed Care, Methodology, PBM / Pharmacy, Value Propositions

Some ACO Facts From Modern Healthcare and CMS

July 5, 2012 by George Van Antwerp 1 Comment

In a Modern Healthcare article about ACOs, there was the following graphic which is a quick snapshot.  The key here is that companies are rapidly moving forward with ACOs (commercial and Medicare).  The initial data is positive, and it seems like everyone is jumping on board.

Books / Articles, Care Management, Healthcare, Managed Care

Healthcare Transparency, Out-Of-Network Claims, and Technology Solutions

June 13, 2012 by George Van Antwerp 0 Comments

Another big focus area these days is around the creation of transparency solutions to enable consumers to make better cost decisions about their healthcare.  While several companies have sprung up to work directly with consumers, the large payers have begun to rollout their own solutions.   And, as you can see from the Towers Watson and National Business Group on Health 2012 Survey, this issue of transparency was the 3rd biggest focus area for 2013. 

If you havent’ heard much about the topic, here’s several articles about the challenge of price discrepancies and surprise bills to consumers:

Here’s what UHG and Aetna are doing:

A few of the companies to look at are:

Companies like GoodRx are creating solutions in this area. 

You also might enjoy this infographic from Change Healthcare.

 

If you don’t believe this is a big issue in terms of price differentials, take a look at this data from the Healthcare Blue Book.  This shows a huge swing in prices which depending on your plan design can directly impact your out-of-pocket spend. 

Test or treatment Low Fair High
Brain MRI $ 504 $ 560 $ 2,520
Chest X-ray 40 44 255
Colonoscopy 800 1,110 3,160
Complete blood count 15 23 105
Hip replacement 19,500 21,148 43,875
Hysterectomy 8,000 8,546 16,480
Knee replacement 17,800 19,791 42,750
Knee arthroscopy 3,000 3,675 7,350
Laminectomy (spine surgery) 8,150 11,744 25,760
Laparoscopic gallbladder removal 5,000 6,459 12,480
Tubal ligation 2,865 3,183 5,729
Transurethral prostate removal 4,000 4,409 8,875
Ultrasound, fetal 120 169 480
Vasectomy 700 1,003 2,100
Books / Articles, Consumerism, Healthcare, Infographic, Innovation, Managed Care, Marketing / Communications, PBM / Pharmacy, Research, Software, Technology

Pediatric Cancer Article in EBN

May 31, 2012 by George Van Antwerp 0 Comments

“In the 1950s and 1960s, 4% of children survived with that diagnosis [leukemia].  In 2010, 80% to 85% of children in all risk categories survived and are cured.”  Dr. Beverly Bell, Medical Director of the oncology program at inVentiv Medical Management

This is a quote from the June 1, 2012 article titled Trial and Error in Employee Benefit News.  It’s an important fact as we watch cancer go from a terminal diagnosis and medical event to a chronic disease.  Working with the survivors is something that Dr. Bell and I have discussed several times.

Here are some other facts from the article:

  • 1/3 of childhood cancers are leukemias.
  • 10,400 kids under 15 in the US were diagnosed with leukemia in 2007.
  • About 1,545 of them will die fro the disease.
  • Approximately 75-80% of pediatric cancer patients are put on a clinical trial.

The article goes on to talk about several things to consider:

  • Plan language modifications.
  • Access to pediatric oncology nurses.
  • Access to a oncology network of centers of excellence.
  • General support for the entire family perhaps through an EAP program.
  • Hospice care.
  • Medical travel / tourism.

Creating a holistic strategy to address oncology is a big effort and one that is critical to helping these patients.

Books / Articles, Care Management, Healthcare, inVentiv Health, Leadership, Managed Care

A Few Basics On Health Risk Assessments

May 30, 2012 by George Van Antwerp 0 Comments

Like many of you, I’ve heard a lot about HRAs (Health Risk Assessments) for years.  A few times I’ve even taken them.  And, depending on your employer, you may even get paid to complete one.  But, what are the basics about HRAs that you should know?

  1. What is a HRA?  An HRA is a series of questions that can be administered over the Internet or by the phone or by a nurse to help collect patient reported data to help screen patients for chronic conditions or risk of developing a chronic condition based on their behaviors or other data.  Additionally, they often lead to either immediate feedback on behaviors to address or lead to the patient being engaged into a program with a wellness, disease management, or case management. 
  2. Should employees be incented to take an HRA?  Incentives are basically used to increase response rates to the HRA.  Not surprisingly, several studies show that incentives work, but education about the need to take the HRA is also important.  In some cases, employers are even linking participation to premiums.  Additionally, here’s a list of the top incentives used based on a 2010 study. 
  3. How should an HRA be used?  An HRA is a key component of an overall care management strategy.  Like claims analysis, the objective of the HRA is a screening mechanism to identify patients who should be included in wellness, disease management, or care management program. 
  4. Are HRAs valuable?  There have been studies over the years that have shown a 2:1 or 3:1 ROI for wellness programs and a ROI for case management.  HRAs are valuable in identifying more patients who should be enrolled in these programs. 
  5. Should you combine biometrics with HRAs?  Here’s a good study that shows that blending lab work with HRA data significantly increases the likelihood of identifying patients with diseases especially kidney disease. 

Of course, no HRA is valuable if:

  • You can’t get enough members to actually take the HRA.
  • You don’t have an engagement strategy to get the members to participate in the program.
  • You don’t continue to follow-up and help the member manage their condition.
  • The member doesn’t get engaged in their healthcare. 
Books / Articles, Healthcare, Managed Care, Methodology, Research, Value Propositions

Costs Of Presenteeism and Absenteeism

April 24, 2012 by George Van Antwerp 0 Comments

At the World Health Care Congress (WHCC), one of the presenters was making a great case for why employers want to continue to be involved in healthcare.  Their point was that the costs of presenteeism and absenteeism are significant and make health a bigger issue than simply the obvious medical and pharmacy claims costs.  (In one study, presenteeism costs alone were more than medical costs.)

While absenteeism costs are obvious as in sick days paid out, presenteeism is harder to estimate but can have significant costs.  Presenteeism occurs when people come to work sick and are not productive.

I’m sure there are numerous methodologies out there, but I found this one that seemed simple and gave me some data by condition on both factors.

Books / Articles, Healthcare, Managed Care, Research, Value Propositions

Why Blending Rx and Dx Data Matters

February 23, 2012 by George Van Antwerp 2 Comments

Yesterday at the PBMI conference, I was listening to a presentation on the blending of pharmacy and medical data. This has been the Holy Grail for a while although companies have struggled to do it well and successfully use it to affect change. That being said, I think it’s one of the biggest focus area for differentiation in the market today. From a large PBM perspective, you can look at the Guided Health efforts at Prime Therapeutics. From a payer software perspective, you can look at Active Health.

Some of the examples from yesterday were interesting data points that you’d never see without digging into both sets of data. For example:

  • 84% of patients using PPIs chronically had no clinical diagnosis to support that
  • 67% of patients taking CNS stimulants had no clinical diagnosis to support that
  • 31% of patients taking atypical antipsychotics had no glucose monitoring
  • 60% of patients taking a psychotropic drug didn’t have a clinical diagnosis

    • Of course, the challenge is not only to identify them but to engage the patient and the provider in the best course of treatment looking at cost, outcomes, and patient experience.

    Events, Healthcare, Managed Care, PBM / Pharmacy, Technology

    NYT Article On ACOs Replacing Health Insurers

    February 4, 2012 by George Van Antwerp 2 Comments

    I think it’s a bold (maybe foolish) prediction that is made in the NY Times article saying that ACOs (Accountable Care Organizations) will be the end of health insurers.  We don’t even know that ACOs will work yet.  You can even see some debate on this topic in this blog post on Why ACOs Won’t Work.

    But, I’m not an ACO expert so let me focus on what I found interesting in the NYT article.  It points out a few things:

    1. The focus on preventative care
    2. The fact that some managed care organizations are changing (and others will too)
    3. The fact that “ACOs” (in whatever form they take) will need a platform

    This is what I find interesting.

    I think the concept of an ACO (or Patient Centered Medical Home) where care becomes localized and there is greater focus on prevention and wellness not just sick-care is great.  We should all want that to happen in some form.

    But, in all cases, this changes the data needs and role of the physician.  They need to be empowered with new information and tools.  How do they manage their panel of diabetics?  Will some database track them and monitor their screenings and blood sugar?

    When the field of medicine is constantly changing with new drugs and new studies, how will physicians have the best practices pulled into their practice?  They won’t want to wait the 16 years it takes for things to work their way through the system.  They’ll actually want to embrace the best solutions and see more comparative effectiveness information.

    I see a huge opportunity here for someone to create an ACO “platform” that embeds business rules, tele-monitoring, consumer engagement, and reporting into a way to create the “i-physician” (informed physician) of the future.

    Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Research, Technology

    Medicare Enrollment Up 1.2M (9.5%) in 2012

    February 2, 2012 by George Van Antwerp 0 Comments

    Based on new data from CMS as shared by CSFB in a report, the enrollment in Medicare Advantage through January 12th is up 1.2M to 13.3M.  This is 27% penetration into the Medicare market.  PDP enrollment was up to 19.69M a similar gain of 1.2M. 

    A quick summary of the big winners are:

    • For Medicare Advantage (by percentage)
      • Humana +13.5%
      • Amerigroup +13.3%
      • Coventry +12.2%
    • For Medicare Advantage (by membership)
      • Humana +262K
      • United +132K
      • Aetna +35K
    • For PDP (by percentage)
      • Coventry +25.3%
      • Cigna +14.8%
      • Humana +12.3%
    • For PDP (by membership)
      • Humana +312K
      • Coventry +291K
      • Cigna +80K

    This is also interesting in light of Kermit Crawford (CEO of Walgreens) comment yesterday:

    “Based on our preliminary analysis of the Centers for Medicare and Medicaid Services (CMS) data, Medicare Part D plans with Walgreens in their network gained market share in the aggregate, while those without Walgreens lost market share. Importantly, we were very pleased to see that those plans that included Walgreens grew nearly twice as fast as those Medicare Part D plans without Walgreens. In fact, several health plans that partnered with Walgreens grew significantly faster. For example, Coventry, who partnered with Walgreens and introduced a low cost Medicare Part D option, grew five times faster than the overall market.”

    The one obvious account that he’s talking about is Wellpoint which lost 2,000 (0.3%) members in MA and 73,000 (11.6%) members in PDP.

    Books / Articles, Healthcare, Managed Care, PBM / Pharmacy

    Uping The RxAnte: An Adherence Predictive Model

    January 30, 2012 by George Van Antwerp 0 Comments

    Those of you that have heard me speak know that I look at this topic of predicting adherence both from an area of fascination along with the eye of a skeptic.  While I love the concept of predicting someone’s adherence and therefore determining how to best support them from an intervention approach, I also believe that the general predictors are pretty straightforward:

    1. Number of medications
    2. Plan design (i.e., cost)
    3. Gender
    4. Health literacy and engagement (see PAM score research)

    And, this is a hot topic (see post on FICO adherence score).  You can see my prior posts on some different studies, on the Merck Estimator, and some notes from the NEHI event on this topic.  It generated a good dialogue on Kevin MD’s blog when I talked about paying MD for adherence.

    I had a chance to talk with Josh Benner the CEO of RxAnte the other day.  It sounds very interesting, and they have an impressive team assembled.  In general, they’re focused on:

    • Predictive modeling
    • Decision rules
    • Monitoring and managing claims to track adherence
    • Evaluating effectiveness of interventions
    • And creating a learning system

    There are definitely some correlations to the work we do at Silverlink Communications around adherence.  We’re helping clients determine a communication strategy that might include call center agents, direct mail, automated calls, e-mail, SMS, mobile, or web solutions.  We’re looking at segmentation and prioritization.  We’re looking at past behavior and messaging.  The goal is how to best spend resources to drive health outcomes from primary adherence to sustaining adherence.  This is a challenge, and we all need to build upon the work that each other is doing to improve in this area.  We have a huge problem globally with adherence.

    Blogroll, Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Research, Silverlink, Technology

    Wellpoint Quote On Drug Copay Cards

    January 20, 2012 by George Van Antwerp 0 Comments

    This topic seems to be heating back up based on several posts on Adam Fein’s blog (Lipitor, adherence) and an article in Drug Benefit News where this quote appeared along with an AIS blog post questioning the PBM’s dislike of copay cards (from the same article that Adam mentioned).

    “Copay offset programs [offered by brand-name drugmakers to compete with generics] mitigate the effectiveness of our tiered benefit design programs and [are] going against what we’re trying to accomplish for our members’ health and for employers.”

    — Peter Clagett, vice president of pharmaceutical strategies and PBM oversight for WellPoint, Inc.

     

    Blogroll, Books / Articles, Healthcare, Managed Care, Marketing / Communications, PBM / Pharmacy, Social Media

    United HealthGroup At CES – Two Videos

    January 13, 2012 by George Van Antwerp 0 Comments

    This is Dr. Crounse from Microsoft talking about worldwide healthcare and using technology.

    This is Dr. Reed Tuckson from United Healthcare talking about creating cost effective healthcare leveraging technology.

    Healthcare, Innovation, Leadership, Managed Care, Technology, Value Propositions

    Who’s the 1% in healthcare?

    January 12, 2012 by George Van Antwerp 0 Comments

    As we all have known, healthcare costs are driven by the minority. According to the Agency for Healthcare Research and Quality, the top 1% account for 22% of healthcare spending in the US or about $90,000 per year. (USA Today article)

    So, what are the characteristics of these people:
    - White, non-Hispanic
    - Female
    - In poor health
    - Elderly
    - Users of publicly funded healthcare

    Only about 20% of the high cost consumers stay in that bucket for two straight years…which I think is good. But, I guess you have to look at what percentage die during that period since a lot of costs are concentrated at the end-of-life.

    Obviously it’s critical to develop solutions to engage and manage these patients earlier in the process. As data gets better, our predictive algorithms around conditions will improve and we’ll be able to intervene and prevent or delay cost in the system. The key of course is doing that in a way that fully engages the healthcare team and the caregivers.

    Books / Articles, Healthcare, Managed Care, PBM / Pharmacy, Research, Silverlink, Social Media, Value Propositions

    Opportunists vs. Solidarity

    December 22, 2011 by George Van Antwerp 1 Comment

    With the Walgreens and Express Scripts dispute unresolved, you are certainly seeing more of an opportunistic attitude in pharmacies than one of solidarity.  Maybe this shouldn’t be a surprise, but early on, I thought that the pharmacy groups would see Walgreens as their “leader” standing up to the large PBM.  If the largest retailer can’t get negotiating leverage over the PBM, can anyone?

    Now, if you go into my local grocery store (Dierbergs), you see signs about moving your prescriptions to them from Walgreens before it’s too late.  You see and hear videos playing throughout the store talking about how to move your prescriptions and how easy it is.

    CVS Caremark is predicting that it could see as many as 23M prescriptions move from Walgreens to CVS stores.

    I’m certainly a fan of preferred or limited networks although I’m not sure I ever imagined a scenario where one PBM would totally exclude one of the big two retailers.  I always imagined a scenario where you were playing them off each other and letting the client choose which one(s) to exclude.

    You can see in the new whitepaper by Walgreens that they point out several things:

    • The savings  being offered / created is likely not enough for clients to want to exclude Walgreens and create the disruption.
    • Clients who can include Walgreens are doing so and others would like to or believe they can.
    • If Walgreens is excluded long-term, self-funded clients will be more likely to consider other PBMs.
    • Many people still think this will get resolved in 2011 or by early 2012.

    This brings up two other discussion topics:

    1. Will they come back?  If the disruption happens (or has already happened), will consumers come back to Walgreens once they are back in the network?  This will be a true test of satisfaction, branding, and many other efforts.  On the flipside, the other retailers should be spending real effort welcoming and trying to retain the new consumers so they don’t boomerang back.
    2. Has the pressure shifted from Walgreens to Express Scripts?  Depending on the timing, Walgreens will have felt most of their pain by mid-January.  At that point, the pressure (IMHO) shifts to Express Scripts.  Will they want to go through their 2012 selling season without Walgreens in their network, a major acquisition in the works, and any other potential distractions?  I wouldn’t.
    Books / Articles, Healthcare, Managed Care, Marketing / Communications, PBM / Pharmacy

    Smoking is an easy target for lowering healthcare costs

    December 20, 2011 by George Van Antwerp 0 Comments

    These statistics from the CDC really paint the picture…

    - Smoking is estimated to cost businesses over $170 billion a year.
    - Every smoker on the payroll is costing the company more than $3,500 annually in increased health insurance premiums, increased absenteeism and lost productivity.
    - Smokers take, on average, 6.5 more sick leave days a year than non-smokers.
    - Smokers cost 35-50% more to insure, a figure which is increasing rapidly as healthcare costs spiral.
    - On average, up to 40 minutes of the working day is spent on smoking breaks, which equates to 21 working days of lost productivity per smoker per year.

    This is certainly why you see companies trying to avoid hiring smokers. For those that show pictures of them smoking on Facebook or in other social media channels, this might be a risk (although I’m not sure if it’s legal to use that).

    Healthcare, Managed Care, Research, Social Media, Value Propositions

    Cost and Outcomes Drive Better Use of Data

    December 8, 2011 by George Van Antwerp 1 Comment

    Overall, I would describe healthcare companies as trying to figure out how to drive the best outcomes at the lowest cost while maintaining a positive consumer experience.  This isn’t easy.  One area of opportunity that companies increasingly look at is how to use data to become smarter. 

    • Can I build a predictive model of response curves?  Who’s likely to respond?  Who’s likely to take action?
    • Can I develop a segmentation model that works?  How will I customize my communications after the segmentation?
    • Can I rank and prioritize my outreaches?  Should I do that based on risk or based on potential value? 

    Ultimately, I think this is driving companies to be a lot smarter and to look at how they use both medical and pharmacy data.  For example, I’ll point to both CVS Caremark and Prime Therapeutics in press releases from earlier this year. 

    “The ActiveHealth CareEngine offers evidence-based information that can be used to improve the health care of our members and enables us to take our programs to the next level by seamlessly incorporating medical data,” stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. “This agreement will enhance our existing programs to identify issues related to gaps in care, potential drug-to-drug interactions and duplicative care — information that is important to bring to the attention of the member’s physician.”  (article that this is sourced from)

    Smart use of medical and pharmacy data is one of the most powerful tools we have to improve outcomes and increase value for our members and clients,” said David Lassen, PharmD, Chief Clinical Officer at Prime. “Through ongoing partnership with health plan clients, Prime is uniquely positioned to view the entire spectrum of patient care, and we can leverage that information to help manage cost and to improve outcomes. We are very excited to collaborate with Corticon on the development of this clinical platform.” (press release)

    The next step will be to integrate PRO (patient reported outcomes) from sources like connected devices and PHR (personal health records) that might show blood pressure, workouts, calories, or other data points that could help companies determine when to intervene and how to add value to drive an outcome.

    Additionally, another key is continued work in the outcomes-based contracting world and bonus areas such as Star Ratings where the financial value is tied in the short-term to outcomes.  This creates a burning platform for smarter use of data and use of a broader set of data to understand and impact care.

    Books / Articles, Healthcare, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Press, Research, Silverlink, Technology, Value Propositions

    State By State Rankings – Key Healthcare Metrics

    December 6, 2011 by George Van Antwerp 0 Comments

    United Health Foundation published their Health Rankings today which offers some great statistics and interactive graphics to see how states compare on things like high cholesterol and diabetes. I pulled a few examples here, but it’s definitely worth checking out.

    Books / Articles, Healthcare, Infographic, Managed Care, Marketing / Communications, Methodology, Research

    Medicare Patients Save $1.5B on Rxs!!

    December 6, 2011 by George Van Antwerp 0 Comments

    Now, here’s a great story.  This may be one of the best government success that I’ve heard about in what I think of as a collaboration of the government with multiple businesses.  (Although I think this is a lot more of what HHS is doing these days under Todd Park’s guidance.)

    According to USA Today this morning, more than 2.65M Medicare recipients have saved an average of $569 per person this year based on addressing the donut hole with a 50% discount on the brand drugs filled during this time.  And, the average premium for 2012 is actually LOWER than the premium in 2011 (by $0.76 per month). 

    The other part of the article is about the potential value of preventative care and leveraging this as part of the Medicare benefit.  The key here is engagement of the participants to help them understand and take action on their healthcare.  The power of the consumer in driving healthcare costs and outcomes is significant which is a topic that I know was discussed by several people today at the mHealth event in DC.

    Books / Articles, Consumerism, Healthcare, Leadership, Managed Care, PBM / Pharmacy, Research, Value Propositions
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