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| Future's so bright, gotta wear shades! |
They're right. Given growing recognition that "health care as usual" cannot continue, companies, vendors and organizations (and blogs) that offer new approaches will thrive. Have a good idea on reducing chronic illness and improving health and the value proposition will follow. Have a value proposition and the business model will follow. Have the business model and an early comfortable retirement will follow.
The report can be downloaded here. No company or individual resource knowledge library is complete without it. The Disease Management Care Blog also thinks that forwarding the report to colleagues, co-workers, bosses, underlings, friends and enemies will demonstrate two key traits:
1) your situational market business awareness is second to none
2) reading the DMCB is a competitive advantage
A DMCB summary review is below
ACOs and Shared Savings: the industry has a host of necessary risk assessment, predictive modeling, information technology, analytics, patient engagement and condition management tools that can be built and tailored. Provider organizations that seek to make money from "upside gainsharing" ignore these resources at their peril.
Electronic and Mobile Health: remote physiologic monitoring, 'app' based coaching and "pull" style social media engagement are all reaching a tipping point. Or rather, are all eReaching an eTipping ePoint. The Disease Management Care Blog, sharing in the eEnthusiasm, has initiated a remote "eSpouse" offering. More on the ePerils of that eBusiness model in a future ePost.
Reducing Readmissions: Come Oct. 1 2012, outlier hospitals with more than their fair share of heart failure, heart attack and pneumonia readmissions can look forward to a painful revenue cut. "Pay us now or pay later," says the industry, with too numerous-to-count proven care management strategies that have been described at the Care Continuum's annual meetings for years.
Medicare Advantage Bonus: That's right, MA plans will be eligible for bonuses from CMS based on HEDIS inspired commercial insurance outcomes that have been the bread and butter of the care management service providers since the beginning of time.
Dual Eligibles: This highly vulnerable population has been trapped in a twilight zone of overlapping and uncoordinated benefit plans thanks to a well-meaning but typical Washington-style mishmash of Medicare and Medicaid. The good news is that the Feds have finally woken up to this and are interested in funding many of the coordination strategies that the population health industry stands ready to offer.
Prevention and Wellness: The Feds have money to put into this and employers are increasingly willing to invest in it. Medicare covers annual wellness visits and covers obesity counseling. The controversial ham-fisted involvement of HHS in calculating the MLR has thankfully correctly slotted the cost of wellness programs. Wellness and prevention are one of the ten essential benefits. The industry is poised and ready to go.
And what about "build" versus "buy" and the notion that providers already know how to do all this stuff? The DMCB points to the sine wave of on-again off-again in and outsourcing that has been the norm for the commercial insurer-disease management vendor relationship for years. The DMCB suspects the same will occur for providers, hospitals, delivery systems and ACOs that have to operationalize complex programs that achieve measurable accountability. The difference is that, up until now, they haven't had to do that at all. Based on a mix of in-house competencies, interest, speed to market needs and cost comparisons, many will buy.
The population health industry's outlook is very bright indeed.
Image from Wikipedia
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