Countdown to the PHA Forum 2015: Meet Peter Goldbach MD

by Gregg A. Masters, MPH

In the full court press for the pursuit and implementation of the many moving parts associated with fulfilling the triple aim, it’s advisable to dial into and take heed from those who’ve been at the table – both in terms of strategy and hands on implementation.Peter Goldbach headshot

Today we hear from one of those accomplished physician thought leaders and key executives with a holistic view of the complex ecosystem of American healthcare delivery and finance.

Peter Goldbach, MD is the Chief Medical Officer of Health Dialog, ‘a total population healthcare services provider that offers risk-bearing entities (health plans, employers and providers) an integrated suite of services driven by powerful analytics.’.

Dr. Goldbach’s journey into the healthcare ecosystem includes a ‘Zeitgeist’ fueled via both medical administration as well as the core granularity associated with operating a primary care and fellowship fueled pulmonary practice, plus powerful insights forged from hands on the forward leaning Blue Cross Blue Shield of Massachusetts ‘pay for performance‘ initiative into value based contracting.

Sourced from Dr. Goldbach’s Health Dialog bio, he brings…:

…more than 30 years of medical experience to Health Dialog’s management team, including 15 years in medical administration and 17 years maintaining a primary care and pulmonary disease practice.

He is also the Chief Medical Officer for Health Dialog’s sister company RediClinic, a retail clinic service provider. Prior to joining Health Dialog and RediClinic, Dr. Goldbach served as President and Chief Executive Officer of Med-Vantage Inc., a healthcare informatics and engagement company.

Earlier in his career, he served as Medical Director for Blue Cross Blue Shield of Massachusetts, where he provided medical direction for the company’s “Pay for Performance” and eHealth programs, and held CEO, trustee, and medical staff president positions with two Boston-area community hospitals. Dr. Goldbach received undergraduate and master’s degrees from UCLA before earning his medical degree from SUNY Downstate Medical Center College of Medicine. He completed his Internal Medicine internship and residency at George Washington University Hospital, and his Pulmonary Disease fellowship at Cedars-Sinai Medical Center a teaching affiliate of the UCLA School of Medicine.

Peter, his colleagues and many industry peers will be attending and participating in the PHA Forum 2015 (see keynote line-up here) in the Nation’s Capitol from November 2nd-4th, 2015. The PHA Forum is the go-to gathering of the best and brightest minds in the emerging if not re-engineered population health management space.

For some of Peter’s earlier work on ‘shared decision making‘ courtesy of our friends at the American Journal of Managed Care see: ‘Peter Goldbach, MD, Talks About Shared Decision Making Practices‘, and via the World Healthcare Congress, here.

Hope to see you in D.C!

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This post is sponsored by the Population Health Alliance (PHA).

 

 

Population Health and the Hearst Health Prize

by Gregg A. Masters, MPH

We’re in the midst of the emergence of a profession and outright industry. ‘Population Health‘ congeals and integrates healthcare stakeholders across a continuum of healthcare infrastructure (acute, chronic, post acute/long term care) spanning public health, the emerging digital health ecosystem (including telehealth and telemedicine), accountable care or clinically integrated, risk bearing delivery systems and the triple aim – better experience of care, improved outcomes at lower per capita costs.

With limited committed academic infrastructure – the Jefferson College of Population Health (JCPH), follow via twitter @JeffersonJCPH, is the sole stand alone academic, degree granting institution in the U.S., and the Journal of Population Health Management a go-to source of empirical knowledge and evidence based best practices are two noteworthy assets.

Enter the collaboration between Hearst Health (follow via @HearstHealth) and JCPH. For context on the Hearst Health Prize for Excellence in Population Health, checkout the interview with Gregory Dorn, MD, President, Hearst Health sourced at the Population Health Colloquium 2015 in Philadelphia earlier this year via our colleague Douglas Goldstein (@eFuturist).

On PopHealth Week this Wednesday, September 16th 2015 at 10:30AM PT/1:30PM ET our special guests include David Nash, MD, MBA Dean of the Jefferson College of Population Health and Gregory Dorn, MD, President of Hearst Health @HearstHealth. PopHealthWeek-logo-TWTTR-sq

Per Hearst Health and JCPH joint announcement:

Population health is essential to transforming from an illness-centered healthcare system to one focused on protecting and improving health.  We created this prize to help promote promising new ideas in the field that will help to improve health outcomes, and thus proliferate best practices more rapidly.  Our goal is to discover, support and showcase the work of an individual, group, organization or institution that has successfully implemented a population health program or intervention that has made a measurable difference.

On the broadcast today, we’ll discuss Population Health and the innovative Hearst Health Prize for Excellence in Population Health. For more information about this competition including eligibility, terms and the application download, click here.

The winner will receive a $100,000 cash prize in recognition of outstanding achievement in managing or improving population health. This award is a combined effort of Hearst Health and the Jefferson College of Population Health.

Join us!

 

Countdown to PHA Forum 2015: Meet Sam Glick @OliverWyman

by Gregg A. Masters, MPH

‘Population health’, ‘accountable care‘, ‘personalized or precision medicine’, or more recently ‘consumer centric healthcare’ – a veritable potpourri of themes du jour or perhaps decades – and the responsible stewardship of U.S. healthcare assets are in a heightened state of dynamic tension. Some with limited ‘event horizons‘ may claim that this contemporary experience of acrimony if not industry disequilibrium, drifting and unrelenting internecine warfare centered on ‘health policy’ (i.e., the American healthcare delivery and financing ecosystem) can be laid at the doorstep of the consideration, passage and now implementation phase of the Affordable Care Act.

PHAForum_keynotesYet for those of us who have been at the strategy table and at the implementation helm for multiple decades, know the truth is a considerably more complex series of questions and answers than the pandemic of sound byte slams via ideological prisms.

So today in our series titled ‘Countdown to the Population Health Alliance (PHA) Forum 2015‘ we dive into that conversation with a seasoned executive and thought leader in the innovation space.PHA Forum 2015_OliverWyman_Consumer_Power

For timely context and consideration of the state of the healthcare ecosystem and our chat with Sam, check out Oliver Wyman’s thoughtful report: ‘The Patient to Consumer Revolution: How High Tech, Transparent Marketplaces and Consumer Power are Transforming U.S. Healthcare‘.

The broadcast will be live and via on demand replay thereafter at PopHealth Week at 1PM PT/4PM ET. Our special guest is Sam Glick, Partner in Oliver Wyman’s Health and Life Sciences practice, and the San Francisco Office Leader. Sam will keynote at the PHA Forum onSafely Navigating the Consumer Healthcare Evolution‘.

His indicated interests include: consumer-centric healthcare, working with leading providers, health plans, employers, ‘enablement companies’, retailers, and venture capital firms to find innovative, engaging ways to bend [the cost] trend.

Sam is an author of several recent Oliver Wyman points of view, including ‘A Billion-Dollar Decision: Charting a New Course for US Healthcare Benefits and ‘Private Exchanges Change the Game. Sam also leads many of Oliver Wyman’s healthcare commercialization research and intellectual capital development efforts.

According to bio copy on the Oliver Wyman site:

‘Sam has been invited to speak at a number of events for healthcare senior executives and board members, including the American Hospital Association (AHA) Leadership Summit, the AHA Center for Healthcare Governance Symposium, the Council on Employee Benefits Annual Conference, the Accountable Care Congress, the Integrated Healthcare Association annual board retreat, the CAPG Healthcare Conference, the Leadership Institute roundtable, and the UnitedHealth Group Smart Circle series. He is quoted regularly in both the industry and popular press.’

Join us for an informative conversation with an industry visionary. We invite you to check out the agenda for the PHA Forum 2015 and consider joining us in the Nation’s Capital for the go-to industry gathering of population health thought leaders, executives and stakeholders on November 2nd – 4th, 2015.

If you are tasked with innovation in service delivery (and financing) strategy at your health system, health plan, physician network, MSO or ACO, please follow us on twitter via @PopHealthWeek and do consider subscribing to PopHealth Week.

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Disclosure: this post is sponsored by PHA.

Former HHS Secretary The Honorable Tommy Thompson on the Affordable Care Act, Prevention and Wellness


On the Wednesday, September 2nd, 2015 at 12 Noon Pacific/3PM Eastern our special guest is the Honorable Tommy Thompson.

Tommy Thompson served as Governor of Wisconsin from 1987
to 2001, and is the longest serving Governor in State history. From 2001 to 2005 he served as the Secretary of Health and Human Service (HHS) under President George W. Bush. After his time in the Bush Administration he served as a partner with the law firm Akin-Gump and the Chairman of Deloitte’s Global healthcare practice. He has also served on the Board of 22 organizations.Tommy_Thompson_headshot

Governor Thompson has a wealth of knowledge regarding health care, Medicare, and prevention.

While Secretary, he launched initiatives to increase funding for the National Institutes of Health, reorganized the Centers for Medicare & Medicaid Services to encourage greater responsiveness and efficiency, and clear the backlog of waivers and state plan amendments. He approved 1,400 state plans and waiver requests and thereby provided health insurance to 1.8 million lower-income Americans. In the aftermath of 9-11 he also worked on strengthening the nation’s preparedness for a bio-terrorism attack, by stockpiling smallpox vaccines and investing heavily in state and local public health infrastructure.

With the continued drone is some camps of calls to ‘repeal and replace’ the Affordable Care Act, including the most recent ‘The Day One Patient Freedom Plan‘, proffered by current sitting Governor and Republican Presidential Candidate Scott Walker, Thompson a moderate Republican voice weighs in on the realities of health reform in the U.S.

Join us for what will be a fascinating journey into the heart and mind of this seasoned politician and healthcare policy giant. We’ll explore his thoughts on the Affordable Care Act, Prevention and Wellness and more.

 

 

Month End Wrap Up and Re-cap: ACOs, Population Health and Stuff

By Fred Goldstein, MS and Gregg Masters, MPH

This week join PopHealth Week hosts Gregg Masters, Doug Goldstein and Fred Goldstein for our month end review. This month’s cFarzad Mostashari MD Health Datapaloozaommentary will touch upon what we learned from our first two ACO guests, Farzad Mostashari of physician led ACO management company Aledade and Gerry Meklaus of Accenture (more on tap for September as the interest level in un-bundling the model types and sharing this experience to date has been quite substantial). phw_aledade

We also discuss a recent interview of Ronald Bayer where he had some pretty strong thoughts on Precision Medicine versus Population Health- see: ‘Precision Medicine a Threat to Population HealthIs it a binary choice and might there be a need for some definitional guidance?

And as is typical Doug (@efuturist) is gallavanting around the world and we’ll get an update from him on his travels, connections and insights from ‘Digital Health España‘ aka Digitalhealth.es. Innovation is NOT limited to the domestic conversation. Doug will fill us in on his discoveries to date.

Katherine Schneider MD | Population Health Colloquium | Delaware Valley ACO
For some insights from the largest ACO in the Delaware Valley, check out Doug’s interview with Katherine Schneider, MD,  President and CEO of Delaware Valley ACO.

And for a developing resource in the digital health space courtesy of Health Innovation Media, check out DigitalHealth.domains an emerging digital health library of sorts.

 

 

 

 

Countdown to the PHA Forum 2015: Meet Christobel Selecky and Sean McNamany

by Fred Goldstein and Gregg Masters, MPH

Join our guests, Christobel Selecky, Chair of the Board and Sean McManamy Board member and Chair of the Population Health Alliance Forum Program committee as we discuss the Population Health Alliance Forum . The Forum now in its 16th year will be held November 2-4 in Washington D.C., is the ‘go to’ event in Population Health for executives, providers, physicians, researchers and population health practitioners. PHAForum_

Chris and Sean discuss the forum theme Welcome to Health: Population One, which underlines all of the presentations and tracks, introducing the concept that changes in a population occur one person at a time.

This year’s keynotes will focus on the upcoming national elections and their potential impact on health care, the 50th anniversary of Medicare and Medicaid and their future, and Consumerism in health care.

Currently announced Keynote Speakers are:

Eleanor Clift (@eleanorclift), a Washington correspondent for the Daily Beast, where she covers the White House and writes about politics and Policy. She also appears on “The McLaughlin Group” and MSNBC.

PHAForum_keynotesMark A. Siegel, (@msiegel271) former executive Director of the Democratic National Committee.  His career has spanned academics, government, politics, the private sector, print and electronic media and film-making.

Dr. William Rogers, Director of the Physicians Regulatory Issues Team at the Centers for Medicare and Medicaid Services (@CMSgov).

Sam Glick, a partner in Oliver Wyman’s Health and Life Sciences Practice (@OliverWyman).

Lucia Savage, the Chief Privacy Officer at the Office of the National Coordinator for Health IT (@ONC_HealthIT).  Her role is to foster interoperability in healthcare while ensuring security and privacy is maintained.

There will also be various tracks targeted toward supplying providers, payers and employers with practical, usable information on all aspects of Population Health. Monday afternoon will include the Executive Institute with a broad array of topics including a surprise session that will be a must attend for those in the employer wellness space.

You can learn more and register for the conference here and keep up with the conference via twitter handle @PHAVoice and conference hashtag #PHAF15. For transcripts, analtics and reach metrics check our the conference digital dashboard.

 

 

Meet Gerry Meklaus Managing Director, Accenture

by Gregg A. Masters, MPH

Before there was ‘accountable care’, the current full court press towards innovation – whether digital health app, platform or service delivery model, an emerging culture of transformation or the attendant pursuit of the triple aim, not to mention the most recent obsession with ‘retail as cure’ for that which ails healthcare, the best and the brightest minds (both clinical and administrative guided by thoughtful health policy wonks) convened in the grand theater of ‘managed care’ or managed competition.

The model and industry writ large (both public and private sectors), variably expressed as HMO, PPOs and derivative strains of contracting models stimulating the development of IPAs, PHOs, PPMC’s, MSOs and DPOs (direct purchasing organizations) had a run from the mid 70s until its abandonment as the official vehicle to restrain the rising cost and variable quality of healthcare in the late 90s. What followed was somewhat of a meandering decade of incremental tweaks here and there to an otherwise burning platform of fee-for-service healthcare delivery and financing.

In 2015 with healthcare costs now approaching 20% of the U.S. Gross Domestic Product and the viability of the entire U.S. Government at risk to projected costs increases and unfunded liabilities of the Medicare and Medicaid programs (estimated at $64 trillion), business as usual fee-for-service medicine is no longer an option and the many cathedrals of medicine built by ‘do more to earn more’ largesse are clearly at risk in the shifting sands of value based care.

While the ‘value’ v. volume agenda has been around for a while via risk based contracting including case rates, bundled payment and even capitation – both global and professional only versions – their penetration of mainstream medicine was relatively modest – until now. That is if you can believe the growing prevalence and penetration of risk bearing ACOs arrangements, a tapestry of bundled payment participation via Federal programs and a less transparent portfolio of privately negotiated ‘value based arrangements’.value based care meklaus

Into this theater steps one of the trophy consulting companies with both wide (global) and deep (extensive client penetration into the health plan, provider and IDN communities) aka Accenture Health (follow via @AccentureHealth).

Developing the narrative with a ‘value tutorial’ of sorts is Gerry Meklaus, the Managing Director of Accenture North America for Clinical & Health Management Services. We speak with Gerry Wednesday at 12 Noon Pacific/3PM Eastern at Pophealth Week where my colleague and co-founder Fred Goldstein, President of Accountable Health, LLC will engage Gerry in the value conversation and the many touch points between a value framework for ACOs and population health strategies of provider organizations.

Key terms to un-bundle and digest are the ‘Big Three’: 1) to ‘improve outcomes’ via emerging best practices, the reduction in variation and effective engagement of the patient in shared decision making, 2) the effective lowering of costs from a ‘total cost of care’ perspective (not just niche wins – if you will), and 3) the well known challenge to de-silo the many silos in the healthcare ecosystem driving fragmentation, redundancy and a less that patient centered experience.

Join us as we gain insight into the challenges and successes in the market to date!

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Originally posted to ACOwatch.com.

 

Another Milestone Marker in Favor of the ACO Model? Meet Farzad Mostashari, MD

by Gregg A. Masters, MPH


I awoke this morning to an email from a PR rep who supports outbound news for one of the emerging ACO management companies enabling physician led participation in the Medicare Shared Savings Program (MSSP) aka Aledade (@AledadeACO).

I then copy, pasted and tweeted the headline: ‘Aledade Creating New Medicare Accountable Care Organizations in Seven States.

I usually ignore ‘PRs’, yet this announcAledade newsement is material as it lends support via a growing body of evidence on the viability of the ACO model and its enabling ‘consciousness’ if not ‘sentiment shift’ in the prevailing market narrative.

While some still slam the ACA – and by proxy it’s ACO ‘workhorse’ – via relentless yet ‘diminishing returnsimpact of the ‘government takeover‘ fear mongering fueled by strategically sourced oppositional research, there is a building steady body of evidence supporting both the model and the broader context of efficacy of the competitive dynamics the ACA has unleashed on the stewards of our at risk (some say collapsing) healthcare economy.

Ergo my tweet:

Aledade news tweet

Ever since the Senate Finance Committee took up the debate and relentless series of ‘amendments‘ proffered by the ‘Rs’ trying to ‘improve‘ the proposed legislation that eventually emerged as the Patient Protection and Affordable Care Act (I NEVER use the pejorative term ‘Obamacare’), I’ve been a voice in the narrative of trying to get the facts of competitive market dynamics into the post political conversation around reforming our complex healthcare economy.

This is no easy task as the complexity of both the political process and objective reporting of how legislation becomes law including its contextual historical narrative is addressed in ‘A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History.

A challenge recognized upfront via admittedly ‘apolitical’ or ideologically agnostic ‘law librarians’ (yeah, you know those agenda driven bullies):

“Using the health care legislation passed in 2010 as a model to show how legislative procedure shapes legislative history, this article posits that legislative procedure has changed, making the traditional model of the legislative process used by law librarians and other researchers insufficient to capture the history of modern legislation. To prove this point, it follows the process through which the health care legislation was created and describes the information resources generated. The article concludes by listing resources that will give law librarians and other researchers a grounding in modern legislative procedure and help them navigate the difficulties presented by modern lawmaking.”

Since social media was starting to pick up in 2009 – 2010 time-frame, and given the angst associated with the public’s consumption of the ACA, I started ACO Watch and latter the hashtag #healthreform to track tweets associated with ACA consideration.

None-the-less, 5 years later the disinformation campaign persists though some of the pieces of the ACA are starting to show some promise of the law’s original intent. ACOs often referred to as a flawed model, perhaps an ACO lite if you will or too little too late to make a difference, the emerging datasets (both government and private market tea leaves) are building a case that the law is working.

Tomorrow on PopHealth Week, join my colleague, co-host and co-founder Fred Goldstein as we chat with Aledade Founder and CEO Farzard Mostashari, MD. This month we’re conducting a series on Population Health and ACOs talking to leadership from each ACO type: physician led, hospital sponsored and health plan enabled.

Listen here! We’re live 12 Noon Pacific/3 PM Eastern, and on demand thereafter.

Original posted on ACOwatch.com.

Population Health Management Framework: Identification of Your Population

by Gregg A. Masters

In this PopHealth Week‘s edition of FredTalk, Fred Goldstein @fsgoldstein highlights the critical first step in the the Population Health Alliance‘s (PHA) Population Health Management Framework, “Identification” of your population….

Population Health and ACOs: A Deep Dive Into Model Type and Results To Date

by Gregg A. Masters

As we continue our journey into population health and it’s relationship to and ACO Watch @ACOwatch @ACOalliancesynergies with all forms of innovation enabling the broad brush outcomes of the ‘triple aim’, better health outcomes, improved user experience and lower per capita costs, we shift our focus to the accountable care industry and ACOs in particular.

The month of August we’ll chat with executives from each of the following types of ACOs: physician led, hospital sponsored and health plan enabled.

On the first broadcast at 12 Noon Pacific/3PM Eastern we’ll provide an overview of the space and touch on the history and origins of ACOs, the motivations of the Affordable Care Act (ACA), then pivot to the pros and cons of the various models in the market and to the extent we can compare and contrast results, we’ll offer up data posted to the public domain.

Join Fred Goldstein @fsgoldstein and Gregg Masters @2healthguru for this exploration into an timely and relevant topic.