THCB

THCB

Giving a Voice To Healthcare’s ‘Unacceptables’

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Humans are aspirational by nature.

We dream big and invest tools that help us dream bigger. But we forget—sometimes willfully—that many of us are being left behind—because of racial, cultural or gender biases; poor access to connected technologies; or social stigmas associated with loneliness and sexual assault.

But if working in healthcare over the past 10 years have demonstrated anything, it’s that we are ready and willing to do something about the problems that keep all of us from looking to brighter futures.

It’s why I am proud to introduce a special session at the 11th Annual Health 2.0 Fall Technology Conference—The Unacceptables. Healthcare has too many innovators, too many dreamers, to empathizers to tolerate forgotten populations.

Leveling the Playing Field

As our society grows increasingly diverse and gaps in health among different populations increase, there is an urgency to develop solutions for underserved communities and diversify the population of innovators who are creating these solutions.

Diversity in Healthcare. As part of its mission to improve health for all, the Robert Wood Johnson Foundation (RWJF) has placed special emphasis on creating diversity in healthcare leadership. Last year, RWJF launched four new leadership development programs to engage people working across a variety of sectors to build a Culture of Health. Hear Michael Painter, Senior Program Officer, discuss how RWJF engages professionals, community advocates and organizers, doctoral scholars, clinicians, and researchers across multiple fields, represented by participants with diverse backgrounds, perspectives, and specialties.

Women in Health IT. The numbers are startling. Women make up 80% of the workforce, but only 4% of CEOs. Women in health IT earn 20% less than their male counterparts, according to HIMSS. Progress has been made, but more could be done (hello, booth ‘girls’, for a start) to address gender roles in our industry. Lisa Suennen, Senior Managing Director Healthcare Investing, GE Ventures, lead Venture Valkyrie LLC, a publishing, and business advisory firm and is a founder of CSweetener, a not-for-profit company focused on matching women in and nearing the healthcare C-Suite with mentors who have been there and wish to give back, and which she writes about here.

Read my full article here

Which of These 10 New Companies Will Change the Face of Health care?

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The Health 2.0 Fall Conference is the perfect place for new and young companies to get a foot in the door – to generate industry buzz, obtain critical funding and pitch new partners.

Our lineup includes:

Our exclusive Launch! event – 10 companies will debut their solutions and have them voted on by the audience.

Henk Jan Scholten, a co-founder of last year’s winner – Siren Care – said, “Launch! was the ideal platform for our product because it’s not only laser-focused on digital health but also has a stellar industry reputation and strong following of innovators and thought leaders. Showcasing our product with a live patient demo on stage gave us instant credibility that is hard to achieve.”

Be sure to also attend Traction, which puts Series A-ready companies center stage as they compete to be recognized as the most fundable start-up from venture capitalists and corporate investors.

BREAKING NEWS: CTO of HHS, Headspace, Google join Health 2.0 – rate goes up tomorrow!

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What do most healthcare shows have in common? The same old, same old. You spend the equivalent of a mortgage payment for the same thought leaders who tell you about the problems in healthcare and the same vendors with products that don’t quite get at the core.

We do things differently at the 11th Annual Health 2.0 Fall Conference. We’ve deliberately curated a wide-ranging, hands-on, attendee-driven experience that focuses on achieving the possible. Check it out:

1. Test-Drive the Tech: Obviously! The agenda and exhibit hall is packed with 150+ tech demos in dozens of product categories. No power points and empty promises. These are products in action and entrepreneurs with real life tales from the trenches.

Check out the latest from such companies as Headspace, Google Play, Welltok, and Microsoft. Want to see what’s really brand new? Check out Launch!

2. Turn point solutions into system change: We go beyond one-off apps to show you how to integrate innovation sustainably. With presentations on FHIR and blockchain; Interoperability; and with live input from providers like Sutter Health, UCSF, Mount Sinai Health System, and more….you will see how to implement change in real life.
3. Get currency and customers. Discover “Series A” finalists at Traction, and meet investors from New Enterprise Associates, Merck Ventures, Humana Health Ventures, Nexus Venture Partners, Kaiser Permanente Ventures, Summation Health Ventures, and more at the Investor Breakfast. Get customers atMarketConnect Live with buyers from Cigna, Sutter Health, Kaiser Permanente, Dignity Health, Stanford Health Care, Providence, and more.
4. Get under the hood. Health 2.0’s Dev Day will be showcasing the latest developer platform updates, and chatting about exciting plans on the horizon for companies working on FHIR, blockchain, machine learning, and predictive analytics. Innovators on hand will include Aashima Gupta, Global Head of Healthcare Solutions at Google Cloud; Adam Culbertson, Innovator-In- Residence at HIMSS; Andrew Shults, Senior Director of Engineering at Oscar, and data guru Fred Trotter.
5. Understand policy to see the opportunity. Policy impacts innovation. Discover how legislation and regulation will impact solutions development and implementation from Bruce Greenstein, CTO of HHS; Don Rucker, National Coordinator at ONC; former ONC Director David Brailer, and former U.S. CTO Aneesh Chopra.

Register today before rates increase by $200 after tomorrow! 

Tackle The Next Wave Of Healthcare Consumerism

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Value-based healthcare initiatives are great, but on their own won’t be enough to bend the healthcare cost curve.

The focus must move—and move quickly—from treating people who are sick to helping them get and stay healthy. The only way that’s going to happen is by getting patients and populations motivated to do the right things early instead of desperate things late.

The New Consumer World of Tools and Health Models
Health plans, in particular, have shifted responsibility onto consumers.

Kyle Rolfing, President and Co-Founder of Bright Health, and Jackie Auba, Vice President of Cigna’s Customer Adoption and Personalization Strategy, will share this shift during the The New Consumer World of Tools and Health Models panel at the 11th Annual Health 2.0 Fall Conference.

At this session you’ll also check out a demo from health optimization platform Welltok. Through population health management we are learning more about how to create wellness strategies and to stratify patient populations based on their conditions and adjust for nuances in age, race, diagnostic groups, and the like.

The Best Part Of The Health 2.0 Fall Conference Agenda

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There’s still time to secure your ticket before prices increase to this year’s Health 2.0 11th Annual Fall Conference. Whether you’re a Health Provider, Entrepreneur or Investor; the Fall Conference is the place to see the latest health technology, to hear from some of the influential innovators impacting the landscape, and to network with hundreds of health care decision makers. Click here for the full agenda.

Health Providers Agenda Highlights 
Entrepreneurs Agenda Highlights 
  • MarketConnect: A live matchmaking event designed to accelerate the health tech buying and selling process by curating meetings between pre-qualified healthcare executives and innovators.
  • Exhibit Hall: Gain access to 90+ exhibitors, including Startup Alley, is the premier gathering of innovative companies and individuals. The exhibit floor is also home to MarketConnect Live.
  • Developer Day: Expect your day to be filled with strong technical sessions in relation to interoperability and user testing as well as opportunities to network from others in the industry.
  • 2 CEOs and a President Session: Three top health tech executives sit down for separate intimate interviews with a journalist. They will be dishing on both their personal and company journeys.
Investors Agenda Highlights 
  • Investor Breakfast: Bringing together leaders in the Health 2.0 investment community and our innovative startup network for an exclusive breakfast meeting.
  • Investing in Health 2.0 Technologies: Panel experts will address what’s in store for the rest of the year and predict the next big bets in Silicon Valley and beyond.
  • Launch!: Ten brand new companies unveil their products for the very first time and the audience votes on the winner!
  • Traction!: Annual startup pitch competition that recruits companies ready for Series A in the $2-12M range. Teams will compete in two tracks, consumer-facing, and professional facing technologies.

Click here to register for the Annual Fall Conference! Prices increase after September 4th!

A Spoonful of Inequality Helps the Medicine go Down

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The conventional wisdom in the circles I hang out in – pro-Hillary, morally conscious,happy bunnies who pretend to enjoy French wine and opera – is that the greatest scourgeon humanity after the bubonic plague is inequality of wealth. They worship Pope St. John Paul Piketty and canonize Archbishop Paul Krugman. Not only is inequality bad for its own sake, they say, it makes people ill, like medically ill.

Their premise always struck me as specious. I once took them through a thought experiment. Imagine, I said, you time travel to the Bengal famine. There was a lot of equality then – people were equally malnourished. Everyone’s ribs protruded equally because of muscle wasting from marasmus. The loss of protein from kwashiorkor made sure everyone’s belly popped out without prejudice. Starvation because of poverty is a great leveler. It cares little about gender, caste or religion. It is non-judgmental.

Confessions of a Health Plan CEO

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flying cadeuciiThe fact that I was once the CEO of a health insurer may cause you to read this with some skepticism.

I invite and challenge your skepticism.  And I will do my very best to keep this piece strictly factual and not stray into the ambiguities that necessarily accompany complicated matters.

So bear with me.

Health insurers are not popular.  No one wants to go to the prom with us.  We have been vilified by no less than the President of the United States.  Heady stuff.  Let us see if this vilification and what I call the cartoonization of insurers has served us well in the healthcare debate.  I think it has not, because for reasons I hope to make clearer, it has taken the focus away from the real causes of our cost and quality nightmares.

Health insurance started in the Depression with the Blues, although they were not at first called that.  They typically were formed by hospitals (the Blue Crosses) and physicians (the Blue Shields), so that some payment for services rendered might be, well, “insured.”  Provider self interest cloaked in the public interest.  Perhaps there was alignment.  And there was a Depression going on after all.

At first, the role of the health insurer was strictly financial.  The insurer financed all or a portion of covered health services, and far, far fewer services were covered then than today.  That’s all an insurer did or was expected to do.  It was not there to manage doctors or hospitals or patients or anything else.  Originally, this financing was done through “indemnity” plans, which allowed patients to see anyone they wanted, and paid a set dollar amount per service or per day of hospitalization (e.g., $50/day of hospitalization).  Thus, if you chose a more expensive provider, the difference was on you.  Insurers back in the day did not negotiate reduced fees with providers (“fee discounts”).  It was much more civil then.

Your Drugs Are About to Get More Expensive

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The Washington Post recently ran an article by Marlene Cimons, a Medicare Part D drug plan enrollee. Her late father had been a pharmacist and he had owned a drugstore while she was growing up. She thought it would be nostalgic to patronize a neighborhood drugstore rather than a big chain pharmacy. She found a neighborhood drugstore in her preferred pharmacy network and had her prescription transfer there. She was stunned, however, when a 90-day prescription that should have required only a $3 co-pay turned out to be $58.

When she inquired the drugstore claimed it stood to lose money on her particular prescription. Who knows; maybe its profit margin wasn’t as high as the pharmacy thought it should be. In order to fill her prescription the drugstore basically required her to willingly pay an extra $55 more than its contractual agreement stipulated. Of course, that violated the contract the drugstore had signed with her Medicare Part D plan. The agreement the pharmacy had signed with her drug plan did not allow it to arbitrarily charge higher prices and Ms. Cimons left without her prescription.

The Mess That is MACRA

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MACRA (the Medicare Access and CHIP Reauthorization Act) is a mess. It is extremely difficult to comprehend, it is based on assumptions that defy commonsense and research, and it may raise costs.

The Medicare Payment Advisory Commission (MedPAC) would never say what I have just said, but MedPAC definitely understands MACRA’s defects. The transcripts of MedPAC’s October 8, 2015 and January 15, 2016 meetings indicate that members and staff perceive daunting impediments to the implementation of MACRA. But those transcripts also suggest that MedPAC won’t tell Congress to rewrite or repeal MACRA. Rather, the evidence suggests MedPAC will mince words. It appears MedPAC will send CMS and Congress a few wishes dressed up as “principles” and wait for MACRA’s inevitable failure before offering more useful advice.

Before I attempt to explain MACRA, let me first convey to you MACRA’s mind-numbing complexity by quoting four commissioners. Each statement below is followed by the last name of the commissioner who made it, the date the statement was made, and the page number of the transcript where the statement appears.