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There’s an app for that

The Denver Post (Tracking your pregnancy on an app may be more public than you think) has published an interesting and disturbing article about the rise of Ovia, an app that collects detailed and personal data from pregnant women and those hoping to conceive. I’m not surprised that the business model is to provide data to employers about their workforce in order to save on medical costs and reduce time away from work. But I am a little surprised at how much data employees are willing to enter on topics like their sex life, color of cervical fluid, miscarriages and so on, while the app also track things like what medical conditions they looked up.

“Maybe I’m naive, but I thought of it as positive reinforcement: They’re trying to help me take care of myself,” said [Diana] Diller, 39, an event planner in Los Angeles for the video-game company Activision Blizzard. The decision to track her pregnancy had been made easier by the $1 a day in gift cards the company paid her to use the app: That’s “diaper and formula money,” she said.

As I remind people using “free” apps –or ones they are paid to use– you’re not the customer, you’re the product. There’s plenty written on this topic so I won’t bother to rehash it here, but it’s worth remembering that the data provided by Diller and others can be combined with tons of other data from their use of Google, Facebook, Waze, exercise trackers, and more to create incredibly detailed and personal profiles.

In 2008 I wrote a brief blog post called Baby formula in the mailbox. “Honey, is there something I should know?” I was puzzled to see that it still gets a lot of hits in 2019 and that readers are still commenting about their own experiences. Back then, an au pair who worked for us had received baby formula from Abbott Nutrition. Somehow, some marketer thought she was pregnant. It was kind of embarrassing and of course could be problematic for a family relationship or if the pregnancy had ended prematurely.

Online data gathering has come a long way in the past decade. If Abbott once guessed you were pregnant, imagine how much more they –or many others– knows about you now. Maybe the users of these apps aren’t naive, just fatalistic about the idea that everyone knows everything anyway, so why not just take the formula and diaper money and run?

In a few years, Diller’s child will probably find the Denver Post article or maybe even this blog post. If that person is you, I’d be interested to know how you feel about it.

By healthcare business consultant David E. Williams, president of Health Business Group.

The post You’ve come a long way baby! And thanks to this app, your mom’s employer knows all about it appeared first on Health Business Group.

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#CareTalk Podcast - March 2019: Gottlieb's Out. What's Next For FDA? - YouTube

The latest edition of #CareTalk is out. CareCentrix CEO, John Driscoll and I explore the departure of FDA Director Scott Gottlieb and other pressing topics.

Here’s what we covered:

(0:28) Scott Gottlieb is out at FDA. Are you sad to see him go?

(2:00) Home health spending is projected to grow faster than any other category of healthcare over the coming years. Is that good or bad?

(4:00) Insulin prices are spiking and both Democrats and Republicans are up in arms. What’s happening?

(5:53) Lyft is talking about the social determinants of health. What?!

(8:47) What do you think about FDA approving ketamine nasal spray as a treatment for depression?

(9:10) What did we learn about healthcare from Michael Cohen’s Congressional testimony?

(9:33) Medicare has a new app. Have you tried it?

(9:59) Did you hear about the $48,500 bill for a cat bite?

Subscribe to the #CareTalk Podcast
iTunes: https://apple.co/2DIDTcr
Google Play: https://bit.ly/2RobqMB

The post #CareTalk March 2019: Gottlieb’s out. What’s next for FDA? appeared first on Health Business Group.

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https://healthbusinessgroup.com/wp-content/uploads/sites/17/2019/03/Rhapsody-podcast-3_17_19-8.42-PM-online-audio-converter.com_.mp3

Interoperability has a been a buzzword in healthcare for about a decade, but sometimes it doesn’t seem like we’ve gotten that far. In this podcast, Rhapsody’s EVP of Product & Strategy, Drew Ivan and I discuss interoperability: its past, present and future.

Here’s what we covered:

  • 0:20 What is interoperability anyway?
  • 2:50 Why do we hear about interoperability so much in healthcare? Is it an issues in other industries?
  • 5:11 How does interoperability in the US compare to the situation elsewhere?
  • 6:51 Does interoperability matter to patients?
  • 9:20 Has interoperability failed in the past? What new models are being tried?
  • 11:54 What’s the business model for interoperability?
  • 13:42 Are there any downsides? Does interoperability create any new problems?
  • 14:54 How will interoperability evolve in the coming year?

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Interoperability in healthcare 2019: Podcast interview with Rhapsody appeared first on Health Business Group.

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Happy 14th!

My main job is president of Health Business Group, a boutique healthcare strategy consulting firm I founded in 2003. As a sideline, I write the Health Business Blog, where I provide a behind the scenes look at the business of healthcare, featuring my spin on healthcare topics in the news, interviews with entrepreneurs, and policy prescriptions.

The blog is turning 14 years old this month!  Continuing a tradition I established with birthdays one,  two,  three,  four,  five,  six,  seven,  eight,  nine,  ten,  eleventwelve, and thirteen I have picked out a favorite post from each month. Thanks for continuing to read the blog!

March 2018: Tufts Health Plan CEO Tom Croswell on value baed care (podcast)

Tufts Health Plan CEO Tom Croswell is a veteran of the health plan world. I sat down with him to discuss value based care, collaboration, diversity and how Tufts tries to set itself apart in a crowded market. Tufts is best known for serving Massachusetts but is also expanding into neighboring states. It has a joint venture in New Hampshire and had just announced its entry into Connecticut in partnership with Hartford HealthCare.

April 2018: Ten pharma policy topics in just one article!

Kaiser Health News is a non-profit news service that does a great job of exploring healthcare policy topics. Still I was impressed that one article (How a drugmaker turned the abortion pill into a rare-disease profit machine) managed to directly and indirectly raise at least 10 important policy topics.

May 2018: Partners and Harvard Pilgrim aren’t really going to merge, are they?

The news was full of stories about merger discussions between Partners HealthCare and Harvard Pilgrim Health Care. No one denied the reports, so we can assume there was some truth to the rumors. But why would these organizations contemplate a merger and how likely would it be to happen? I compared it to a scene from a Cheech & Chong movie.

June 2018: Boston Globe and Boston Herald quote David Williams on Harvard Pilgrim CEO departure

A month after Harvard was talking about merging with Partners, the company’s CEO was out. It had something to do with his behavior… Both the Globe and Herald wanted to hear what I had to say about departed CEO, Eric Schultz.

July 2018: Nurse triage lines 3.0. Podcast with AxisPoint Health

Nurse triage lines have gone through three phases of evolution. In phase 1 they were implemented to ‘check the box’  for member education, phase 2 brought “demand management” to keep patients out of the emergency room, and now in phase 3 health plans are creating a gateway to innovative programs and services.

I discussed these topics with a leading company in the field.

August 2018: John McCain. A healthcare legacy

We don’t normally think of Senator John McCain as a healthcare leader, and yet he played a significant role over the years in various policy matters. CareCentrix CEO, John Driscoll and I paid tribute in a short edition of #CareTalk.

September 2018: Reference based pricing for pharmaceuticals. Podcast with ActiveRADAR CEO David Henka

Pharmacy Benefit Managers (PBMs) claim to keep drug costs under control, but their convoluted business models and tactics don’t always result in the best deal for employers. Reference based drug pricing is an interesting alternative approach. It’s used for drug cost control in other parts of the world and within the US for things like elective surgery.

October 2018: Whatever happened to consumer directed health plans?

A sad story for consumers

“Consumer directed health plans” were all the rage in the mid 2000s. The big idea was that if patients had ‘skin in the game’ in the form of greater financial participation in the cost of their care, they would use their well honed shopping skills to find the best deals and thereby drive costs down and value up. Employers embraced the idea, since it could reduce their costs and keep employees happy.

But it didn’t really work out, as I explain.

November 2018: A couple observations about Tuesday’s elections

Checking the box

Healthcare was on the minds of mid-term voters in November. Candidates emphasized healthcare in their campaigns and voters in at least six states had an opportunity to weigh in on healthcare via ballot questions.

Voters were being asked to decide some fairly technical questions, including whether dialysis center profits should be capped in California, whether hospitals should have to maintain specific nurse staffing ratios in Massachusetts, and whether Medicaid eligibility should be expanded or current expansions extended in Idaho, Utah, Nebraska and Montana.

December 2018: #Caretalk year in review from Amazon to Russia

In this end-of-2018 edition of #Caretalk, Carecentrix CEO John Driscoll and I banter about Amazon, drug pricing, immigration, home health, Russia, the ACA and more. I wanted to call this episode “If You Want to Destroy my Healthcare” but was told the Weezer reference was too obscure.

January 2019: Medicaid buy-in. A sensible approach for coverage and cost

Show me the coverage!

The term ‘Medicare for All’ is being bandied about as the campaign for the Democratic Presidential nomination gets underway. Declared and potential candidates are warming to the idea. It’s easy to see why.

However, I’d much rather see attention turn to continued expansion of Medicaid, specifically by offering people the opportunity to ‘buy-in’ to Medicaid coverage.

February 2019: Agenus plans digital security offering. PCG’s Jeff Ramson explains in this podcast

Biotech company Agenus is launching a “digital security offering” that will let people invest directly in a single biotech product, rather than the whole company. Jeff Ramson, founder and CEO of strategic communications firm PCG Advisory Group, became fascinated by the concept and reached out to me to discuss it, even though he is not involved in the offering. (And neither am I.)

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Happy 14th birthday to the Health Business Blog appeared first on Health Business Group.

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The latest edition of #CareTalk is out. CareCentrix CEO, John Driscoll and I explore Medicare for All and other big topics.

Here’s what we covered:

(0:35) Is “Medicare for All” quickly becoming a litmus test for Democratic presidential candidates?

(2:45) What should be made of the recent moves of home health agencies around primary care?

(5:00) Are pharma rebates to blame for increased drug pricing?

(8:00) President Trump promised a whopping $50 million a year for childhood cancer. What would you do with all that money?

(8:32) Will adding the full list price of drugs in ads make a difference?

(9:03) Will Donald Trump actually end HIV transmission by 2030?

(9:32) We predicted that the Patriots would win the championship this year. What about the other Boston sports teams?

Subscribe to the #CareTalk Podcast
iTunes: https://apple.co/2DIDTcr
Google Play: https://bit.ly/2RobqMB

The post #CareTalk February 2019: Medicare for All? appeared first on Health Business Group.

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Partners HealthCare moved quickly to appoint Dr. Anne Klibanski as interim CEO after the resignation of Dr. David Torchiana. I was quoted in the Boston Globe story about it:

The Boston health care consultant David Williams said naming an interim CEO gives the board some time to conduct a thorough search for a permanent replacement.

“They have a history of taking a senior physician and making them CEO of Partners,’’ said Williams, the president of Health Business Group. “Now I think they’re not sure if they want to do that again or if they want to look more broadly for, say, a business person.”

Partners would be wise to thing long and hard about what kind of a person should lead the organization. It may also be time to confront some of the internal contradictions and misalignments within the system and to consider restructuring. That may await the next CEO.

—-

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Partners names interim CEO. I’m quoted in the Boston Globe appeared first on Health Business Group.

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Partners HealthCare moved quickly to appoint Dr. Anne Klibanski as interim CEO after the resignation of Dr. David Torchiana. David Williams was quoted in the Boston Globe story about it:

The Boston health care consultant David Williams said naming an interim CEO gives the board some time to conduct a thorough search for a permanent replacement.

“They have a history of taking a senior physician and making them CEO of Partners,’’ said Williams, the president of Health Business Group. “Now I think they’re not sure if they want to do that again or if they want to look more broadly for, say, a business person.”

The post David Williams comments on Partners interim CEO in Boston Globe appeared first on Health Business Group.

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https://healthbusinessgroup.com/wp-content/uploads/sites/17/2019/02/agenus-token-offering-.mp3

Biotech company Agenus is launching a “digital security offering” that will let people invest directly in a single biotech product, rather than the whole company. Jeff Ramson, founder and CEO of strategic communications firm PCG Advisory Group, became fascinated by the concept and reached out to me to discuss it, even though he is not involved in the offering. (And neither am I.)

In this podcast, we cover the following topics:

  1. Agenus is launching the first asset-backed digital security offering in healthcare. What does it mean?
  2. What is a Biotech Electronic Security Token (BEST)? What are the trends it leverages?
  3. How is it being used?
  4. Has something like this already been used in other industries?
  5. What are the advantages? How does it preserve shareholder equity?
  6. Any disadvantages?
  7. Why not a traditional stock offering?
  8. What is PCG Advisory Group and what is your role?

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Agenus plans digital security offering. PCG’s Jeff Ramson explains in this podcast appeared first on Health Business Group.

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Boston Business Journal quoted David Williams about the sudden departure of Partners HealthCare CEO, Dr. David Tochiana:

“(Torchiana) tried to rationalize the organization and make Partners into a real company with more centralized decision-making, and make Partners itself mean something other than just the General and the Brigham,” Williams said. “It’s not surprising that he wasn’t successful. I don’t know if the next person will be successful either, if they will take the same route.”

Williams said whoever replaces Torchiana will have to be politically savvy to navigate those waters, but added, “even that might not be enough.” One option, he said, would be a restructuring of the organization into a group of separate hospitals that just share administrative resources.

The post Boston Business Journal quotes David Williams on Partners CEO departure appeared first on Health Business Group.

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For the past 14 years, Massachusetts Health Quality Partners (MHQP) has published results of its primary care patient experience survey. The information is useful to the practices themselves as they seek to improve, and to health plans looking to evaluate their networks, improve member service, and pay bonuses to the best practices.

This year MHQP added an analysis of free text feedback to its analysis, to give practices more color on the scores.

The consumer-facing site, Healthcare Compass lets users view ratings for individual practices and compare up to three at a time. Users can click on the individual categories to learn what each one means, what patients can do, what doctors can do, and where to find additional resources. For example, the “what you can do” tab in the communications section includes suggestions to speak up if you want your doctor to make eye contact and to ask the doctor to repeat back what you just said.

I used the site to compare three practices I am familiar with and the results match up well with my perceptions.

Comparing MD offices Click on the Harvey ball to see the underlying data

There is a lot to like about MHQP’s patient experience reporting including:

  • It provides validated information on key elements of practices, for both adult and pediatric
  • The site is easy to navigate. The information is communicated in plain English and with simple, intuitive graphics. For even more detail, you can click on the Harvey balls (I didn’t realize this at first) to get the detail behind the score.
  • Providers have responded to the feedback by improving performance in key areas over the years, including communications and care coordination
  • The bottom line “willingness to recommend” percentage provides a useful benchmark for comparing practices
  • For the first time this year, MHQP issued awards for the highest performing practices for adults and pediatrics and for each domain of care. You have to go to the MHQP site itself to see it, but you can bet the doctors know it’s there!

MHQP has built trust with providers and payers by working collaboratively with them and taking their sensitivities into account when publishing the performance data. Here’s how public reporting of survey results could expand, subject to the consent of providers and payers and additional funding:

  • Provide more prominence to the actual scores for the measures, rather than just a three-level Harvey ball (full, half full, empty) showing relative performance. The current approach obscures the fact that median scores for certain categories are much higher than others. For example, the mean score for pediatric practices on patient-provider communications is 97.3% compared with 50.3% for empowering patient self care. While we’re at it, it might also be nice to see the range of scores. Does everyone cluster around 50% for self care or do some practices get into the 70s or 80s?
  • Provide reporting at the level of the individual MD for measures where that’s relevant, e.g., “how well doctors communicate with their patients” and “how well doctors know their patients,” while keeping practice-level reporting for measures such as, “getting timely appointments, care, and information.” The challenge here is that it would require a much bigger budget to reach the needed sample size
  • Provide a synthesis of the qualitative comments
  • Provide ratings of specialists as well as primary care

The pushback will be that there are valid reasons to present the information as it is and that expanding will be cost prohibitive, but on the other hand it would make this reliable and validated information more likely to be used.

Congratulations to MHQP for its continued success in shining a light on patient experience and making useful information available to all the stakeholders in the Massachusetts healthcare system.

By healthcare business consultant David E. Williams, president of Health Business Group.

The post Experiencing Patient Experience results from MHQP appeared first on Health Business Group.

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