Health plan execs shift focus to technology

Although the focus of discussion among health plan thought leaders who convened in Florida last month at The Managed Care Executive Group ran the gamut from care management to meaningful use, to medical informatics, payment reforms, HSAs and more, technology’s role in the industry’s success was evident.

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Led by industry experts, the 23rd Annual Forum focused heavily on considerations—such as whether this is “the end of health care as we know it,” a conversation that has been floating around recently. Other discussions centered around “innovation and technological change,” "making the leap from volume to value,” “Federal plans, programs and challenges” and “how the social organization might tap the collective genius of health plan communities.”

Each year MCEG compiles a list of issues considered most important to its members via polls, surveys, webinars and other events.

Beyond more complex issues being considered, this year's top 10 shifted most significantly from a year ago with “Bending the Cost Trend” becoming the number one concern. Things like reform uncertainty and consumer roles, which were hot topics a year ago, gave way to new issues such as big data warehousing and analytics, along with PHI privacy and security.

"This year there was an overwhelming sense that everything seems to be a top priority. Bottom line, the biggest challenge health plans are facing is staying focused on the issues that are aligned with their strategies," says Vince Ferri, Chairperson of MCEG and VP and CIO of AvMed Health Plans. "The Forum discussions provided critical insight for MCEG members to consider relevant factors that will lead to their health plan’s success."

Voted and ranked as the Top 10 health plan issues in 2012 were:

1. Bend the Cost Trend in both Medical and Administrative Expenses (Tie with # 2)

2. Care Management, Data Analytics, and Informatics to Improve Outcomes (Tie with # 1)

3. New Provider Payment Models & Delivery Systems (ACOs, PCMHs)

4. Medicare, Medicaid and Other Government Programs

5. Health Information Exchanges (HIEs)

6. Big Data, Warehousing and Analytical Capability Expansion

7. Payer/Provider Interoperability (Tie with # 8)

8. Administrative Simplification, Mandates and Efficiency (HIPAA 5010, ICD-10, MLR) (Tie with # 7)

9. Health Insurance Exchanges (HIXs) (Tie with # 10)

10. PHI Privacy and Security (Tie with # 9)

Two other issues—innovation and collaboration of business and IT as well as transparency of pricing, outcomes and operations—were very close to making the top 10, noted the survey results.

“The way MCEG members address these issues will be critical to their success in 2012 and beyond,” says Alan Abramson, SVP & CIO of HealthPartners, Emeritus Chair of MCEG and the recipient of the 2012 MCEG Alumni Award. "The discussions these last three days have been the best we have had in 23 years and we invite all health plan executives to join us in continuing periodic panel discussions and next year’s forum on their impact and implications."

Pat Speer is the editor in chief at Insurance Networking News, a SourceMedia publication.

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