Joan Harvey, SVP, Consumer Health Engagement & Behavioral Health at Cigna and Rich Berner, CEO of MDLIVE, share insights on using AI and new technology to meet consumers where they are and provide better health care.
Humana Segment President, Beth Bierbower and Geisinger EVP & Chief Innovation Officer, Karen Murphy, on the stigma of addiction and mental health disorders and how to address the public health crisis we are struggling with today.
Key Takeaways: It is no secret that addiction and depression rates are rising, but it is only recently that the health care industry has begun making strides to address these problems and move beyond opioids in treatment of pain.
By Michaela Katz
The opioid crisis has taken thousands of lives and rates of opioid prescription, addiction and overdose have increased dramatically during the past decade. But how did we get to a place where this was considered normal?
“The prescribing of opioids in medicine has led to the increase in addiction across the country. That’s evidence based,” said Karen Murphy, EVP and Chief Innovation Officer at Geisinger in an interview at the Health Evolution Summit. “I think the other mention is an increase in all types of diseases of despair and the self-medicating that’s happening across the country.”
Treatment for opioid addiction exists but, for several reasons, people often don’t seek treatment.
“There are a number of barriers to treatment. I think stigma is a big challenge where people are embarrassed to seek help and in self-denial, thinking that they don’t have a problem,’ added Beth Bierbower, Segment President of Humana in the same interview. “People oftentimes just don’t know where to turn to get help.”
Beyond shame or societal stigma is the fact that mental health is viewed differently than other aspects of health.
Given how much we know about the need for proper treatment of mental health disorders and addiction and the role that stigma plays in accessing treatments, it is important to address these growing trends not only with direct treatment but, also, with efforts to quell negative stigmas.
“Certainly when people take a health risk assessment, we do ask questions around alcohol use and substance abuse,” said Bierbower. “It’s really important how you phrase those questions to be able to elicit the right, accurate responses.”
In addition to asking the right questions, the right way, education needs to change to better be able to respond to, prevent and treat health problems like mental health and addiction that have previously been separated from health care.
“This is the largest public health crisis we’ve ever had. We have to start in basic education,” said Murphy, “The beginning of education has to start in health professionals’ basic education. So starting with medical school education of not only opioid prescribing but the challenges and triggers of addiction…alternatives to opioids and, the dangers really, of prescribing opioids.”
Further to acknowledging and eliminating stigma, changing health care education and better understanding the risks of opioid use and triggers of addiction, it is important that health care more broadly consider opioid alternatives.
“The other part is looking at different ways to manage pain. Where the first line of defense was opioid prescription for the last 2 decades, now we’re looking at other alternatives, more holistic alternatives” said Murphy, “At Geisinger, we’re looking, for example, at using virtual reality as a therapeutic.”
Beyond addressing societies response to addiction and mental health problems it is important to be better equipped to predict and prevent addiction.
“One of the things I think we can do better is, how do we start to anticipate somebody who might be at risk?” said Bierbower, “If we could start to recognize that when major events happen in people’s lives, that this is an opportunity for us to maybe get ahead of it and start to educate people about some avenues they have to seek help even before the problem is there.”
Blue Cross and Blue Shield of Minnesota President & CEO on the need to switch to value-based care and the lessons we can learn from other consumer-focused industries.
Key Takeaways: Shifting from fee for service to value-based care is critical in today’s industry. Craig Samitt shares insights about the need to move to value-based care and how the industry can do better in this shift.
By Michaela Katz
Moving from traditional fee for service to value based care promises large opportunities to drive prevention, address broad aspects of health and ultimately transform care.
It seems time that health care companies begin looking at their value beyond that of treatment.
“I think the greatest opportunity is for us to think as wellness companies, social determinant of health companies, protect and prevent companies, not just treatment,” said Craig Samitt, President & CEO of Blue Cross and Blue Shield of Minnesota in an interview at the Health Evolution Summit.
Despite the amazing possibilities that value-based care holds, the health care industry has not fully embraced value-based care as the majority type of provider service.
Progress in committing to value-based care has been slow and obstacles seemingly unmoving.
“I don’t think we’re changing fast enough. The problems that we struggle with or the obstacles to our progress are the same today as they were a year ago, 5 years ago and 10 years ago,” Samitt said. “We’ve been talking about value-based transformation. I actually sense we’re not making progress fast enough in the right direction.”
What are some of the challenges standing in the way of value-based care?
“My sense is that the challenge in the industry is that the profitability of sickness exceeds the profitability of wellness,” said Samitt.
If this is the case, then changes need to be made that financially incentivize wellness.
“We just need to be much more progressive and forceful in driving to value-based payment,” Samitt added.
That’s probably easier said than done but perhaps competition will drive this shift.
“We need to turn the traditional elements of our industry …on its head. I actually value greater competition. I value the vertical integration. I value the innovators and the disruptors,” said Samitt, “The outsiders, so to speak … look at an industry that could improve in service, and access and cost and they have nothing to lose. I would like us, the incumbents, to reinvent health care from the inside out. I think we can do it.”
Marc Boom discusses what Houston Methodist is doing to increase efficiency and lower costs while keeping the patient at the heart of its work.
Key Takeaways: Innovation is driving changes and leading to more efficient, cost-effective and patient-centered health care. Houston Methodist says recent innovations have been successful in a number of areas.
By Michaela Katz
“Innovation has always been part of the fabric of who we are,” said Marc Boom, President & CEO of Houston Methodist in an interview at the Health Evolution Summit.
Houston Methodist is striving to make innovative thinking an even more central part of its values.
“We created our Center for Innovation,” said Boom. “They call themselves the DIOP group. It’s Digital Innovation-Obsessed People and when they wanted to change the name to something more formal, I wouldn’t let them because I think it captures perfectly the spirit of everything we’re doing.”
The DIOP group is charged with a daunting task but is fully supported by Boom and the Houston Methodist executive team. “We’ve charged them, resourced them, put the people in place to help them, and said ‘go,’” Boom explained.
Innovation is not without failure, but Houston Methodist discourages letting setbacks slow or stop the process.
“We expect that that there will be some bumps along the way, we expect that some things may not work out and, when they don’t work out, we’re going to quickly make a decision and move on to the things that do [work out],” Boom added.
This method and support of innovation has lead to a number of successes. “DIOP already had a number of really big wins,” said Boom. “We’re really focused on how to make the consumers’ lives better, how to meet patients where patients want to be met, and we have made a lot of progress in our market. That’s been very exciting.”
One example of where innovation is paying off is in AI and robotics — particularly robotic process automation, which Boom said is having an impact on the institution.
What inspires the innovations at Houston Methodist? The answer is simple: the patient.
“Everything is about the patient. When people always keep that focus, then we come up with great ideas,” Boom said. “Everything else follows if we think about the patient first.”
GE Ventures former CEO Sue Siegel and Section 32 Managing Partner Mike Pellini discuss the four aspects of health care coming together to advance diagnostics in ways never before possible.
Key Takeaways: Diagnostics in health care have historically fallen short compared to other sectors in terms of both spending and research. However, increased demands regarding personalized medicine, predictive measures and early identification of disease are pushing the industry to enable new breakthroughs in diagnostic science.
By Michaela Katz
Today, there is a huge disconnect between diagnostic spending and the health care industry’s reliance on the tools and findings. At the same time it’s becoming increasingly clear that diagnostics will only become more important, if not strategic, in the massive shift toward value-based care.
“Two percent of the spend goes toward diagnostics — and it fuels 70% of the spend on the decisions made from it,” said Sue Siegel, CEO of GE Ventures and Chief Innovation Officer of GE in an interview at the Health Evolution Summit.
This balance clearly doesn’t make sense but, fortunately, things are beginning to change.
“Diagnostics used to be about the today, and diagnosing disease, and now we’re moving into a world where it’s all about potentially diagnosing something…where there might be no action ability, or prediction. And there’s power to that,” Siegel noted.
What’s driving this opportunity to make diagnostics a more valuable part of the equation?
“There’s an emergence of data, the utilization of data, the mining of data in a way that we’ve never really been able to do until this point in time,” said Mike Pellini, MD, Managing Partner of Section 32 and Chairman of Foundation Medicine in the same interview.
Data is just one piece of the equation. Another is the emerging technology that enables new capabilities every day and not just for diagnostics or health care but for every industry.
“We have data, we have technology, we have diagnostics and we have therapeutics, and all four of these pieces are coming together in a way that we’ve never seen in our lifetimes or, frankly, anyone’s lifetimes,” continued Pellini.
It is clear that acknowledging the value of and increasing investment into diagnostics will have a large impact. This increased emphasis will allow for the application of predictive analytics, will decrease spending for unnecessary treatments and lead to earlier and better treatments of serious and life-threatening diseases.
Beyond its impact in the clinical setting, diagnostics will have far-reaching effects in areas key to the changing health care ecosystem.
“Diagnostics drives personalized medicine,” Pellini said. “Diagnostics are the linchpin to success in personalized medicine. Diagnostics are the linchpin to even value-based care.”
Siegel emphasized the importance of the potential role of diagnostics in achieving value-based care, “With the change into fee for value and what’s happening in the health care system, diagnostics has to play a role that is much more powerful than it’s had a chance to play in the past.”
Dean discusses the importance of shared values and common goals in the recent CHI/Dignity Health merger and his work in addressing drivers of health and health inequities.
Key Takeaways: As mergers in the health care industry are becoming increasingly common, it is important that consumers understand how these mergers will affect (and benefit) them and that mergers work to better address health care’s most serious problems.
By Michaela Katz
CommonSpirit, the product of the union of CHI and Dignity Health, has recently joined other companies including Cigna/Express Scripts, CVS/Aetna and Advocate/Aurora in the sweeping trend of consolidation.
“At the center, our objective was to create something that is patient centric and better than they could get without us in their lives,” said Lloyd Dean, CommonSpirit CEO in an interview at the Health Evolution Summit. “You would feel and see in a very tangible way that you are at the center of your health care journey.”
But what exactly does that mean?
Dean said the answer resides within three key goals CommonSpirit is pursuing. The first is the ability to get your own medical information.
“You would have access to your data, when you go to see a physician or when you get labs, within 12 hours,” Dean explained. “Those will be readily available to you and not just in the normal language but in language that you understand. You would feel that you’re in control of what happens.”
Second, care will not be confined solely to the traditional hospital locations. “We will have brought health care to you,” he said. “It would not be predominantly acute, campus-based care.”
The third goal is connection to and genuine interaction with your provider. “You would be able to interact with your provider in a way that you feel that you are the most important thing in that transaction.”
CommonSpirit is working to use things like Google Glass which will enable providers to develop deeper relationships with their patients by reducing their need to fill out forms and spend time looking at electronic medical records.
The ultimate metric of success is not the goals that CommonSpirit has set but how patients respond to the care CommonSpirit is providing.
“Our true measurement of all key things that we’re doing is not what we hope to achieve but, whether the patient says, ‘That’s the kind of care I want, when I want it, how I want it and I understand it and I feel like I’m in control,’” Dean said.
In addition to the lofty goals Dean hopes that the CHI/Dignity health merger will accomplish, he also wants to continue addressing drivers of health and health equity. “I think [the industry’s] focus on social determinants is long overdue.”
CommonSpirit, for its part, is making investments with communities, giving non-interest loans to other community groups, doing outright grants to address determinants and chonic conditions in particular, Dean said.
“Health care is a right,” he added. “It is not some luxury or something for the most privileged and, for the health and wellbeing of our society, it makes sense.”
Feinberg said the transformation will require a new business model that does not involve ads or targeting individuals for health care services the way Google’s other businesses do today.
Key Takeaways: Feinberg joined Google because of its ability to reach billions of people. Achieving that and fixing the fundamental problems in health care, however, will require a new mindset of the company.
By Michaela Katz
When former Geisinger CEO David Feinberg, MD, left the health system to join Google, he was attracted to the company’s broad reach and the ways that can be leveraged to make more people healthier.
“There’s a fundamental problem in our health system,” said David Feinberg, MD, VP of Google Health in an interview at the Health Evolution Summit. “It’s a system that’s designed around providers. It’s designed around doctors and nurses and hospitals. Every other service industry is derived around consumers.”
It is time that companies in health care begin rebuilding the system and focusing on patient experience. But what is Google doing in the health care industry?
To some, it might seem like an odd pairing but, Feinberg said it’s a natural association. “Whether we call ourselves a new entrant or not, I think we’re already there when we look at the millions and millions of people that do a Google search for health care every day. When we look at the percentage of patients that go to Google 24 hours before any ER visit, it’s a huge number. So, we are in health care.”
Although Google may be in health care, Feinberg is hoping that he can make Google healthier. “I’m trying to turn Google totally into a health care company.”
Not surprisingly, Google as a health care company will be a completely different business model than what exists today.
“As we roll out what we think we’re going to do in the health care space, there will be no ads; there will be no targeting you as a customer,” Feinberg said. “If you’re giving us personal information, we want to have a very, very strong and easy way for you to say, ‘Okay, I’ve changed my mind. I want to pull that back.’”
At its core, Google’s impact in health will be its existing ability to reach people at scale.
Feinberg, who recently started at Google after a successful tenure as Geisinger CEO, noted the company’s large reach as something that excited him about working with Google — particularly being able to reach billions of people and treat them the way he would patients.
Feinberg added that Google’s foray into health care will bring a different type of health to people. “People actually don’t want health. They want their life to be such that they don’t have to ever worry about their health so they can get on with their life. That’s being helpful in peoples’ lives.”