Kaiser Permanente CIO Philip Fasano wrote an excellent book on Healthcare IT - a must read to learn more about both IT in the health care space and Kaiser. Mr. Fasano's move to the largest health insurer is a significant tell for our business, notably the increased reliance on big data as well as the alignment of insurance companies and care providers.
Pharmaceutical and biotechnology companies should prepare themselves to meet the risk sharing demands from the increasing number of ACOs in the coming years, according to new research from HRA – Healthcare Research & Analytics. In the company’s most recent study, Accountable Care Organizations: Partnering for the Future, ACOs are increasingly looking for risk sharing to become part of standard contracting agreements with manufacturers in the near future.
According to input from 100 accountable care organizations, 8% of Medicare ACOs and 4% of Commercial ACOs already have active risk-sharing programs with manufacturers. The risk-sharing models vary across ACOs, but the message is clear that the organizations expect manufacturers to have a stake in patient outcomes.
“We need you to come to the table and say – ‘we want to partner with you and the providers to share risk’,” says Edward D. Shanshala, CEO at Ammonoosuc Community Health Services, a key opinion leader (KOL) interviewed as part of the study.
While managing the health of a population is a noble cause and logically should fall under the purview of a health system (at least according to the federal government), there is little, if any, evidence that the current obsession with taking global risk for the management of the health of a population will end any better than it did in the 90s. Here are 10 reasons why capitated risk is still not likely to take hold anytime soon:
I've read most of the books on this list. Many are must reading if you want to be informed on healthcare. "Reinventing American Health Care" by Ezekiel Emanuel was not a overtly political diatribe as Dr. Emanuel is want to do, but rather a thoughtful explanation (slanted of course) of how we got here and where reform should take us. Overtreated is excellent. Anything by Dr. Atul Gawande is a must read. Some are dated. Some are business fluff - Blue Ocean Strategy and Christensen's works come to mind. However as many of their concepts have passed into the lexicon of business the ideas should at least be familiar to you.
Clinical efficacy is a critical component for medical device manufacturers to consider. It is no longer enough just to innovate or have a new shinny widget to boost sales. Insures, payers and care providers are increasingly looking to the medical results for the equipment they allow. This is a good trend - one that will have serious results if you are not prepared. Case studies, ROI and peer reviewed data on your devices are going to be required if your products will be accepted and purchased going forward.
This is where IT sales and dollars will be found. The survey of 70 College of Healthcare Information Management Executives members by data solutions vendor Health Catalyst found 54 percent rate data analytics as their highest IT priority. Other top priorities included population health initiatives, ICD-10, accountable care initiatives and consolidation-related IT investments.
This article proves that while you can debate if the reform we got was the reform we needed you can't argue the need for reform. Hospital leadership continues to posture, obfuscate and down right mislead consumers of their services. What is going to get this to change?