This morning at the 2014 Health Datapalooza, AHIP President and CEO Karen Ignagni delivered remarks on the ways health plans are using data to fundamentally change the game, putting patients in the driver’s seat of decision making.
Too often the focus on “patient-centered care” leaves patients on the outside with little support or access to the care they need. Health plans are changing that and putting patients at the center by improving care coordination among providers, realigning payment structures to improve the value of health care services, and providing individuals and families with the information they need to make the health care choices that are right for them. Big data is at the center of all of these efforts to deliver on the promise of patient-centered care, but more needs to be done to make data actionable and accessible to consumers.
Below are excerpts of her remarks at the event. Watch the video below for footage from today’s session. Her full remarks can be found here.
On health plans’ role in data innovation: “…Create a 21st Century health care delivery system that works when people want it and where they want it.”
“In terms of a shared agenda, health plans are changing the game on the reimbursement, benefit, and patient support side, using technology created by many of you. The name of the game, together, is to create a 21st Century health care delivery system that works when people want it and where they want it. We understand our role, as the hub of interconnectedness, the importance of continuous innovation, the importance of transparency, and the importance of game changing. I want to challenge each of you to work with us to continue to improve what we are able to do for patients and providers. I want to challenge each of you to work with us to break down barriers. And I want to challenge each of you to address the threats that stand in the way of the next generation of products that patients need and want.”
On delivery system reform: Using data “…To provide care in context, not care in a vacuum.”
“We’re overhauling the benefit structures to create more value for patients. How are we doing that? We’re incentivizing preventive care, we’re rewarding participation in care coordination, marrying this with payment reform to incentivize the choice of effective and efficient clinicians and hospitals…We’ve done it by understanding two fundamental things: we are the only entity in the delivery system that has a line of sight into where patients go and when they go there through all their encounters. We’re the only entity that has the ability to link all these encounters and provide data to physicians to help them provide care in context, not care in a vacuum. The tools are familiar to all of you and the subject of significant attention at important conferences such as this. But in our world, they are not next generation, but they are fundamental building blocks of what we do.”
On the importance of health plans’ data to improve care coordination: “We turn individual practitioners and hospitals into a team.”
“First, through predictive modeling, we are giving physicians line of sight into who is likely to have a chronic illness. Second, through tech support, we’re helping clinicians reach out and touch patients, reminding them to come in for checkups, immunizations, and enabling patients to check their progress to achieve their health care goals. Third, through looking at patterns of care, we are addressing readmissions and wide variations of practice patterns by giving data back to physicians and physician groups and allowing them to talk about it in shrink variation, starting with their leadership. In other words, by creating a feedback loop through data, we turn individual practitioners and hospitals into a team…”
“Care coordination programs used to improve health through team-based care all being supported by data. And we’re performing two fundamental roles. We’re providing interconnectedness and support systems for patients and providers. In the process, I hope this will be positive news to all of you, we’ve build a business case for data sharing and showing results.”
On making data more accessible: “Empower patients by creating actionable information.”
“On the patient side, we’re working with many of you to create decision support tools, next generation, such as cost calculators and other support systems that will empower patients by creating actionable information. Do I stay inside a network or do I go outside? What will be the cost to me if I do? How do I know that physicians inside versus outside have the right quality and the right experience? And how can I make sure that I’m in the place that I want to be? There are mobile applications to simplify and support patients’ use of the system. We’re working with many of you, not only to execute those and use them now… but to actually improve the ability to allow patients to do a number of things with mobile apps that 10 years ago we never thought were possible.”