Author: pauln
Kevin Volpp: Behavioral Economics and Automated Hovering
RAND: Santa Monica Wellbeing Project
http://wellbeing.smgov.net/
Click here to read more about each panelist, including:
- Saamah Abdallah, New Economics Foundation
- James Anderson, Bloomberg Philanthropies
- Sarah Burd-Sharps, Measure of America
- Anita Chandra, RAND Corporation
- Elizabeth Cox, New Economics Foundation
- Lew Daly, Demos
- Nancy Etcoff, Harvard and Massachusetts General Hospital
- Carol Graham, Brookings Institution
- Jon Hall, United Nations Development Program
- John Helliwell, University of British Columbia
- Tim Kasser, Knox College
- Ewen McKinnon & Lisa Ollerhead, Cabinet Office, UK
- Lori Nathanson, Yale Center for Emotional Intelligence
- Gwyther Rees, University of York
- Gus Speth, Vermont Law School
- Arthur Stone, University of Southern California
- Mathis Wackernagel, Global Footprint Network
- Benjamin Warner, Jacksonville Community Council Inc.
- Liz Zeidler, Happy City Initiative, Bristol
Also the New Economics Foundation – economics as if people and the planet mattered.
http://www.neweconomics.org/teams/entry/Well-being
http://www.rand.org/blog/2015/04/wellbeing-project-to-weave-science-into-government.html
COMMENTARY
(Santa Monica Daily Press)
April 29, 2015
Wellbeing Project to Weave Science Into Government Decisions
Photo by paylessimages/Fotolia
Today the City of Santa Monica is releasing the initial findings of a robust research project that aims to measure the wellbeing of Santa Monica’s residents. The findings will serve as a baseline for how the community is doing now so that wellbeing can be tracked on an ongoing basis. While important, the findings that are being released are only a small part of Santa Monica’s Wellbeing Project. The project is working to fundamentally change how the government thinks about its citizens, by integrating the science of wellbeing into its very foundation.
But what is wellbeing? Are we saying that Santa Monica is measuring how happy people are? Certainly that is a factor, but wellbeing is much more than only happiness or wellness. Wellbeing is about individuals having the skills and opportunity to live a meaningful life. There are countless things that cities do that either contribute or detract from that sense of meaning. The Wellbeing Project is about collecting data on a range of factors, linking across findings, and then translating these findings into action.
Santa Monica is the first to more fully relate both the subjective and personal experiences of its residents to specific conditions that support or detract from wellbeing. That is groundbreaking. In other words, Santa Monica and its partners have identified specific, measurable conditions that directly influence personal and subjective wellbeing. To do this, several dimensions of the wellbeing experience were identified including the social, physical and economic environment. Once these dimensions were defined, the city collected and examined a range of data across agencies and sectors at the city level, as well as through resident survey and social media, in order to create a baseline of wellbeing in the community.
Creating a baseline of wellbeing for Santa Monica required unprecedented examination of what data the city currently collects. This motivated a real examination of whether current city data systems support the ongoing monitoring and evaluation of wellbeing, and whether the volumes of data that cities often collect have the signal value to inform policies and programs that actually promote wellbeing. While cities collect data all the time, a full examination of how disparate sources of data connect and how it can be used to inform government decisions that support wellbeing is novel.
The important distinction of the city’s efforts is the difference between data, information and insight. Collecting immense amounts of data does not automatically lead to information. The data must be analyzed and distilled into something translatable and consumable. Additionally, information alone does little good unless the city can learn from the findings and take action upon them.
This initial findings release is only the beginning. Now the city is enhancing the conversation about how government, its partners, and the community work together to cultivate a community that thrives and flourishes. And the city is examining whether it has the data organizational culture, and concurrent governance structure it needs for wellbeing decision-making. We now have the framework in place to propel the city into action, so that Santa Monica can lead the charge in examining the roles and responsibilities of the city government in the 21st Century.
Anita Chandra is a senior policy researcher and director of RAND Justice, Infrastructure, and Environment at the nonprofit, nonpartisan RAND Corporation.
This commentary originally appeared on Santa Monica Daily Press on April 28, 2015.
Where years of life come from – Simon Wilcock
“Perhaps someone should let the minister know that a quarter of a century of additional life expectancy has been granted to each Australian since the Anzacs landed at Gallipoli, and health analysts clearly attribute most of the improvement to fundamental increases in standards of living (eg, housing, sanitation and health literacy), basic preventive measures such as vaccination, and an improved identification and management of chronic disease within community-based health services.”
Simon Wilcock
http://www.australiandoctor.com.au/opinions/guest-editorial/time-to-freshen-up-the-health-reform-script
Time to freshen up the health reform script
Health Evolution Summit – Overview
http://www.healthevolutionsummit.com/Default.aspx?PageID=16199729
1:00 pm – 2:15 pm
Pre-Summit Sessions (concurrent)
CEOs of leading providers/payers share their outlook on their critical innovation priorities and highlight respective approaches to vet solutions. A variety of provider/payer executives then connect with innovative CEOs from relevant service, IT and product companies to learn about new solutions and provide insights on the solutions’ value to the market.
Pavillions IV & V
Payer Connect: Where payer executives and innovative CEOs meet
Select health plan CEOs will share their strategic forecasts and the critical innovations necessary to remain competitive in a dynamic market. Payer executives and CEOs of relevant health service, IT and product companies will network briefly to share ideas and make a plan to reconnect pending mutual benefit.
Moderator:
Mike Gaffney, Co-Founder and Managing Director, EDG Partners
Speakers:
Dan Hilferty, President and CEO, Independence Blue Cross
Steve S. Martin, President and CEO, Blue Cross and Blue Shield of Nebraska, Summit Chair
Networking tables will be hosted by:
Aetna – Bjorn Thaler, VP, Head of Corporate Development
Blue Cross & Blue Shield of Nebraska – Steve S. Martin, CEO and Lew Trowbridge, President and Chief Operating Officer
Blue Cross & Blue Shield of North Carolina – Andy Brynes, VP, Strategic Development, Mosaic Health Solutions
Cambia Health Solutions – Ben Albert, Operating Partner, Rob Coppedge, SVP Strategic Investment & Corporate Development
Highmark Health – Nanette DeTurk, EVP, Chief Administrative and Strategy Officer and Treasurer
Independence Blue Cross – Terry Booker, VP of Corporate Development and Innovation, and Tom Olenzak, Managing Director Strategic Innovation Portfolio
Salons I & II
Provider Connect: Where provider executives and innovative CEOs meet
Select provider CEOs will share their strategic forecasts and the critical innovations necessary for their organizations to remain relevant and competitive. Provider executives and CEOs of relevant health service, IT and product companies will briefly network to share ideas and make a plan to reconnect pending mutual benefit.
Moderator:
Robert Wah, MD, Chief Medical Officer, CSC; President, AMA
Speakers:
John Brooks, President and CEO, Joslin Diabetes Center
John D. Doyle, President and CEO, Ascension Holdings
Michael Wagner, MD, FACP, President and CEO, Tufts Medical Center
Networking tables will be hosted by:
Dignity Health – Richard Roth, Chief Strategic Innovation Officer
Hospital Corporation of America – Chip Blaufuss, AVP of Strategic Innovation
Kaiser Permanente – Chris Stenzel, VP of Business Development and Innovation
Stanford Health Care – Kash Kapadia, VP and General Manager, Digital Health
Sutter Health – Peter Anderson, Chief Strategy Officer
Swedish Medical Group – Ralph Pascualy, Chief Executive
2:15 pm – 3:15 pm
The Monarch Bay Sunset Terrace
The Monarch Bay Sunset Terrace
Alumni Reception
Before the Summit begins, relax and reconnect with fellow alumni. All Summit alumni welcome to attend.
2:15 pm – 3:15 pm
Monarch Pool Terrace
Monarch Pool Terrace
First-Time Participant Welcome
Meet fellow first-time Summit participants. All first-time Summit participants welcome.
General Session: Emerging (and Decaying) Models
The Summit explores the macro implications of emerging (and decaying) models in health and the micro implications that flow from them through a lens that cuts across traditional industry lines of health care services, health IT and life science. Sessions explore the economic underbelly of big issues in search of sustainable business models, directional opportunities and Beachheads.
3:30 pm – 3:45 pm
Salons III & IV
Salons III & IV
Opening Comments
Patrick Geraghty, Chairman and CEO, GuideWell and Florida Blue, Summit Chair
Ann H. Lamont, Managing Partner, Oak HC/FT Partners, Summit Innovation Chair
Charlie Martin, Chairman and CEO, Martin Ventures
Julie Murchinson, CEO, Health Evolution Summit
3:45 pm – 4:30 pm
Salons III & IV
Salons III & IV
A Perspective with Steve Hemsley
Interviewer:
Todd Cozzens, Partner, Sequoia Capital, Summit Innovation Chair
Speaker:
Steve Hemsley, CEO, UnitedHealth Group
4:30 pm – 5:20 pm
Salons III & IV
Salons III & IV
Building the Business Case for High-Priced Therapeutics
Specialty drugs in the U.S. now comprise more than 25% of total pharmaceutical spend and the annual cost per patient can be as high as $100,000 per year. By 2020, the cost of specialty drugs is projected to quadruple and cost the nation more than $400 billion. Is the high-priced approach the new business model for innovation? Are there economically rational reimbursement approaches for certain high-costs diseases? Leaders with high stakes in the game will explore these trade-offs, emerging approaches and financing mechanisms.
Moderator:
Arnold Milstein, MD, MPH, Professor of Medicine, Director of Clinical Excellence Research Center, Stanford University
Speakers:
Joshua Ofman, MD, MSHS, SVP, Global Value and Access and Policy, Amgen
Tim Wentworth, President, Express Scripts
5:20 pm – 6:00 pm
Salons III & IV
Salons III & IV
The Consumer-Engaged Enterprise
To both attract and retain customers, even the most well-established, integrated delivery networks are striving to re-engineer their approach to consumer-centric convenience and service. Meanwhile, newer companies are striving to demonstrate an entirely new level of consumer experience with tools and delivery models that speak to consumer interests. Hear from an established integrated delivery system and a novel primary care model on what is working and where they are headed.
Moderator:
Brad Fluegel, Chief Strategy and Business, Development Officer, Walgreens Boots Alliance,Summit Partner Committee
Speakers:
Rushika Fernandopulle, MD, MPP, CEO and Co-Founder, Iora Health
Glenn D. Steele Jr., MD, PhD, President and CEO, Geisinger Health System
6:00 pm – 9:00 pm
Dana Lawn
Dana Lawn
Welcome Event
Dinner served
9:00 pm – 11:00 pm
The Terrace Salon Balcony
The Terrace Salon Balcony
Après Dessert and Digestifs
APRIL
30
THURSDAY
6:00 am – 7:00 am
The Gazebo
The Gazebo
Morning Fitness Boost
Summit Run, hosted by HealthLine
7:00 am – 6:00 pm
Salon Foyer
Salon Foyer
Registration Open
7:00 am – 8:00 am
The Monarch Bay Courtyard
The Monarch Bay Courtyard
Breakfast
7:00 am – 8:00 am
Salon I
Salon I
Breakfast Session
Profitable Innovation: Invention, Commercialization, Execution
Facilitated by Dentons
Facilitated by: Bruce Fried, Partner, Dentons with panelists: Ronald Kuerbitz, CEO, Fresenius Medical Care North America and Ed Dougherty, Principal, Dentons
Senior executives in every sector of the industry are charged with delivering value. Some need to shorten time to market, others need to produce near term ROI, and others still need to deliver quality healthcare services and improve treatment outcomes in an increasingly price-sensitive environment.
On the eve of the Kentucky Derby, we award the ‘Triple Crown’ to healthcare executives, whose success depends on winning multiple races: being responsive to investors, compliant with regulators and innovators, and delivering affordable, high quality products and services for providers and patients. This session will discuss keys to winning the healthcare triple crown including a baseline model, synthesizing the global clinical and business literature, and testing this model against panelist and audience experience and expertise. Participants will leave with a framework within which to test concepts presented throughout the Summit against the real opportunities and constraints of the business of healthcare.
General Session: Emerging (and Decaying) Models
8:00 am – 9:00 am
Salons III & IV
Salons III & IV
The CMS Perspective: Where Do We Go From Here?
Interviewer:
Bruce Bodaken, Visiting Scholar, Brookings Institution and former Chairman and CEO, Blue Shield of California, Summit Chair
Speaker:
Andy Slavitt, Acting Administrator, Centers for Medicare & Medicaid
9:00 am – 10:00 am
Salons III & IV
Salons III & IV
The Real Deal: Taking on High-Cost, Complex Patients at Scale
Despite challenges, we are seeing an incredible wave of new solutions in caring for populations with multiple chronic diseases, more significant behavioral health issues and complex social situations. Many suspect these solutions will have even more opportunities ahead as they transform individual care. Hear payer, investor and innovator perspectives on what can really be achieved and what new opportunities have yet to be tackled.
Introducer:
Guy Eiferman, Senior Vice President, Strategic Planning and Managing Director, Healthcare Services and Solutions, Merck
Moderator:
Mark D. Smith, MD, MBA, Founding President, California HealthCare Foundation, Summit Chair
Speakers:
Adam Boehler, CEO, Landmark Health
Jay M. Gellert, President and CEO, Health Net, Inc.
Leeba Lessin, President and CEO, CareMore Health System
Thomas A. Scully, General Partner, Welsh, Carson, Anderson & Stowe
10:00 am – 10:30 am
The Monarch Bay Courtyard
The Monarch Bay Courtyard
Morning Break
10:30 am – 11:20 am
Salons III & IV
Salons III & IV
Size Matters: New Approaches to National Provider Brands
Even the most notable regional systems face a growth dilemma, causing some to explore innovative approaches to national expansion, unburdened by brick-and-mortar models. Cleveland Clinic and DaVita HealthCare Partners are on the forefront of these efforts, and others are not far behind. How are best-of-breed providers thinking about scale, how are they ensuring quality and how will they avoid obstacles seen in past waves?
Introducer:
Kris Joshi, PhD, Executive VP, Products, Emdeon
Moderator:
Michael E. Chernew, PhD, Leonard D. Schaeffer Professor of Health Care Policy and Director, Healthcare Markets and Regulation Lab, Harvard Medical School
Speakers:
Toby Cosgrove, MD, President and CEO, Cleveland Clinic
Kent Thiry, Co-Chairman and CEO, DaVita HealthCare Partners
11:30 am – 12:30 pm
Deep Dive Sessions
Salons II
What the Consumer Really Wants: Data Insights into Purchasing Behavior
Hosted by Aon
Facilitated by Matt Levin, EVP and Head of Global Strategy, Aon and Janet Faircloth, SVP, Strategy and Solutions, Aon
Pavilion I
Big Brains on the Internet of Things (IoT)
Hosted by Box
Facilitated by Aneesh Chopra, former CTO, White House, President Obama with panelists: Aaron Levie, CEO, Box; Lee Shapiro, former President, Allscripts and Bill Russell, CIO, St. Joseph Health System
Salon I
Transparency of Cost and Quality: Changing Consumer Behavior at Scale?
Hosted by Emdeon
Facilitated by Doug Ghertner, President, Change Healthcare and Jason Gorevic, CEO, Teladoc
The Plaza
The Next Holy Grail: Strategic Cost Control
Hosted by Healthagen
Facilitated by Charles Kennedy, MD, Chief Population Health Officer, Healthagen
12:30 pm – 2:00 pm
The Monarch Bay Courtyard
The Monarch Bay Courtyard
2:00 pm – 2:50 pm
Salons III & IV
Salons III & IV
Harnessing the Reality of End-of-Life
End-of-life care accounted for over 28% of Medicare’s budget—or $170B spent in the last six months of life for Medicare beneficiaries alone. According to the Institute of Medicine, enhancing the quality of medical and social services at the end of life would create substantial progress toward a sustainable U.S. health care system. Now more than ever, end-of-life services are becoming a strategic industry priority. Two prominent payers and a health system leader will discuss the most critical issues, where best economics are emerging and potential models for advancing management of end-of-life care.
Moderator:
Alexandra Drane, Co-Founder and Chair of the Board, Eliza Corporation; Co-Founder, Engage with Grace
Speakers:
Mark B. Ganz, President and CEO, Cambia Health Solutions, Summit Chair
Wright R. Lassiter, III, President, Henry Ford Health System
Harold L. Paz, MD, MS, EVP and Chief Medical Officer, Aetna
3:00 pm – 4:00 pm
Deep Dive Sessions
Pavilion I
Busting Myths about the 50+: Tracking that Works
Hosted by AARP
Facilitated by Jody Holtzman, SVP Thought Leadership, AARP, with presenter Brad Fain, Principal Research Scientist, Head of the Human Systems Engineering Branch, Georgia Tech Research Institute and panelist Julio Corredor, Director, Worldwide Innovation
Salon I
The Complexities of Patient Financial Responsibility
Hosted by Availity
Facilitated by Russ Thomas, CEO, Availity with panelists; Alan Levine, CEO, Mountain States Health Alliance, Rob Coppedge, SVP Strategic Investment and Corporate Development, Cambia Health Solutions, and Sam Khashman, President and CEO, Imagine Software
The Plaza
Agile Health – New Models of Care Need New Models of IT
Hosted by CSC
Facilitated by Robert Wah, MD, Chief Medical Officer, CSC, and President of the AMA and Lisa Pettigrew, Industry General Manager, Global Healthcare, CSC
Salon II
Zip Code-Driven Health Insights…More Informative than Genetic Code?
Hosted by Optum
Facilitated by Paul Bleicher, MD, PhD, CEO, Optum Labs, and Dave Dickinson, Chief Innovation Officer, Optum Labs
4:00 pm – 6:00 pm
The Monarch Bay Courtyard
The Monarch Bay Courtyard
Afternoon Break
4:15 pm – 5:15 pm
The Terrace Salon
The Terrace Salon
Confab of Women Building Impactful Companies
Join an unmoderated discussion among female healthcare leaders focused on what it takes to build strong teams, how to bring out the best “male” and “female” traits, what “female” traits provide distinct advantages, and what women are getting it done and why.
Speakers:
Gail Boudreaux, Former CEO, UnitedHealthcare
Alexandra Drane, Co-Founder and Chair of the Board, Eliza Corporation; Co-Founder, Engage with Grace
Ann H. Lamont, Managing Partner, Oak HC/FT Partners, Summit Innovation Chair
Lisa Suennen, Managing Partner, Venture Valkyr
6:00 pm – 7:00 pm
Pacific Promenade Lawn
Pacific Promenade Lawn
Global Health Reception
7:00 pm – 9:00 pm
The Pacific Promenade
The Pacific Promenade
The Big Dinner
Global Disease: How New Investment Priorities Are Changing the Landscape
As the Bill & Melinda Gates Foundation works with its partners to transform lives in developing countries, they are acutely focused on tapping into the talent and resources of the private sector. If Ebola taught us anything, low-cost, sustainable solutions need to be created and delivered to ensure not only local and global health, but also economic viability for all. Enter stage left…opportunity. Sue Desmond-Hellmann will share the business case for the global frontier.
Introducer:
Robert Margolis, MD, CEO Emeritus, HealthCare Partners, Summit Chair
Interviewer:
David Brailer, MD, PhD, Managing Partner and CEO, Health Evolution Partners; Chairman, Health Evolution Summit
Speaker:
Sue Desmond-Hellmann, MD, CEO, Bill & Melinda Gates Foundation
9:00 pm – 11:00 pm
The Plaza
The Plaza
Après
Blackjack and poker overlooking the Pacific.
MAY
01
FRIDAY
7:00 am – 12:00 pm
Salon Foyer
Salon Foyer
Registration Open
7:00 am – 8:00 am
The Monarch Bay Courtyard
The Monarch Bay Courtyard
Breakfast
General Session: Disruptive Models
Disruption is happening in pockets, at varying paces and in a variety of ways. In 2015, the Summit explores where new innovations are seeing landfall and the army of others just behind.
8:00 am – 9:00 am
Salons III & IV
Salons III & IV
Moon Shots on Health
Moon Shots – big thinking and aiming for breakthroughs instead of incremental improvements – this is the Google[x] mandate. Google has disrupted just about everything we can think of, so what are they up to in health? Will they be the creator or a potential competitor? The former head of the largest health plan in the country shares her perspectives on moon shots…potential profiles, obstacles and how the practical realities of the past may be shifting. Together, this session will raise the stakes and foreshadow areas where we see breakthroughs instead of barriers.
Moderator:
Peter Neupert, Operating Partner, Health Evolution Partners and Former Corporate VP, Microsoft Health Solutions Group, Summit Chair
Speakers:
Gail Boudreaux, Former CEO, UnitedHealthcare
Andy Conrad, PhD, Head of Life Sciences, Google
9:00 am – 9:30 am
Salons III & IV
Salons III & IV
Consumer On Ramps – Disruptive Models Creating Value
As health care endeavors to engage consumers in their health, some companies are also beginning to create efficiencies, support evolving reimbursement streams and position for value creation. From searching for health information to being monitored remotely; from the healthy consumer to those managing chronic disease or facing acute conditions—the early adopters are contributing to the new health economy. This session will highlight a few innovators disrupting information flow and creating value through the holy grail of the consumer engagement.
Moderator:
Brandon H. Hull, Managing General Partner, Cardinal Partners, Summit Innovation Chair
Speakers:
Eric Rock, CEO, Vivify Health
Ben Wolin, CEO and Co-Founder, Everyday Health
9:30 am – 10:25 am
Salons III & IV
Salons III & IV
Corporate Venture Takes Hold of Health Care
Creating a corporate venture group is certainly one of the hippest strategies to hit the health industry in years. And while these ventures all hope to capitalize on the next biggest disruption to hit the market, they will not all look the same in their pursuits. Hear what disruptive models are on the horizon, what factors are being considered and what you can expect.
Introducer:
Mark Speers, Partner and Managing Director, Health Advances, LLC
Moderator:
Lisa Suennen, Managing Partner, Venture Valkyrie
Speakers:
Rob Coppedge, SVP Strategic Investment and Corporate Development, Cambia Health Solutions
Dave Schulte, Managing Director, Kaiser Permanente Ventures
David Stevenson, Managing Director, Global Health Innovation Fund, Merck
Rafael Torres, Head of Healthcare, GE Ventures
10:25 am – 10:30 am
Salons III & IV
Salons III & IV
Comments and Transition to Innovation Activities
Julie Murchinson, CEO, Health Evolution Summit
10:45 am – 1:00 pm
The Plaza
The Plaza
Corporate Venture Action Group
Innovation Activities (concurrent)
Innovators and health leaders roll up their sleeves in an intimate and interactive setting to explore opportunities.
10:40 am – 11:40 am
Salon I
Salon I
Innovations with Traction: Straight Talk from Customer CEOs
Patient retention and new patient acquisition have always been strategic imperatives, but their importance has risen to mission critical in the transition from fee-for-service to fee-for-value. While these areas may have great impact on both risk of lost revenue and new growth opportunities, they have not been easy problems to solve—and several innovative solutions have stalled. A leading health system CEO talks with innovators about the range of challenges health systems are facing, the approach that different companies are taking and the successes that organizations are experiencing to ensure true value is realized.
Facilitator:
Roy Smythe, MD, Chief Medical Officer, AVIA
Speaker:
Rodney F. Hochman, MD, President and CEO, Providence Health & Services
Innovators:
Mark Hefner, CEO, Infina Connect Healthcare Systems
Oran Muduroglu, CEO, Medicalis
10:40 am – 11:40 am
Pavilion II
Pavilion II
Disruption in Progress: Designing for the Consumer
Innovators and health care leaders on the consumer front lines retreat to the boardroom to explore how best to design for the consumer. Innovators are encouraged to roll up their sleeves in this intimate discussion exploring critical needs, while potential payer, provider and retailer customers help to inform design and their approach.
Facilitator:
Joshua Riff, SVP, Consumer Products, Optum
Contributors:
Rushika Fernandopulle, MD, MPP, CEO and Co-Founder, Iora Health
Jeffrey Kang, SVP, Health and Wellness, Services and Solutions, Walgreens Boots Alliance
Tej Shah, SVP, Business Development, Blue Cross Blue Shield of Louisiana
10:40 am – 11:40 am
Pavilion III
Pavilion III
Disruption in Progress: Where Life Science Is Headed:
Opportunities Beyond the Pill
Innovators and life science leaders retreat to the boardroom to explore new opportunities beyond the pill. Innovators are encouraged to roll up their sleeves in this intimate discussion exploring critical needs, while potential pharma, biotech and medical device customers inform their solutions and their approach.
Facilitator:
Naomi Fried, PhD, VP of Innovation, Medical Information and External Partnerships, Biogenidec
Contributors:
Guy Eiferman, SVP, Strategic Planning and Managing Director, Healthcare Services and Solutions, Merck
Diego Miralles, MD, Global Head of Innovation, Janssen Pharmaceuticals, Johnson & Johnson
Pascale Witz, EVP, Global Divisions and Strategic Development, Sanofi
11:45 am – 12:45 pm
Pavilion IV
Pavilion IV
Disruption in Progress: Care Delivery Innovation
Innovators and health care leaders on the front lines of care delivery retreat to the boardroom to explore how to best to design solutions to improve care and reduce cost of delivery. Innovators are encouraged to roll up their sleeves in this intimate discussion exploring critical needs, while provider executives share the value they are seeking and how potential solutions are vetted behind closed doors.
Facilitator:
Molly Coye, MD, Chief Innovation Officer, UCLA Health System
Contributors:
Lyle Berkowitz, MD, FACP, FHIMSS, Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital
Chip Blaufuss, Assistant VP Strategic Innovation, Hospital Corporation of America
Birthe Dinesen, Professor, Department of Health Science and Technology, Aalborg University (Denmark)
Chuck Dowling, CEO, DiabetesAmerica
11:45 am – 12:45 pm
Pavilion V
Pavilion V
Disruption in Progress: Connecting with Capital
Innovators and seasoned investors retreat to the boardroom to connect on the capital landscape: opportunities on the horizon, what investors are seeking, and what they may require in the coming years. Innovators are encouraged to roll up their sleeves in this intimate discussion to ask their burning questions and to hear from the veterans.
Facilitator:
Jodie Emery, Partner Healthcare and Private Equity, Caldwell Partners
Contributors:
Thomas Carella, Managing Director, Merchant Banking Division, Goldman Sachs
Brandon H. Hull, Managing General Partner, Cardinal Partners, Summit Innovation Chair
Noah Knauf, Managing Director, Warburg Pincus
Ravi Sachdev, Partner, Clayton, Dubilier & Rice
Jeffrey: On millimorts and microlives…
Very good, very interesting piece on risk measurement and reporting…
http://www.jeffreybraithwaite.com/new-blog/2014/11/20/youll-be-dying-to-hear-about-this
You’ll be dying to hear about this
There’s lots of death in the world. Transport is risky, for instance—planes, automobiles, trains and ships can crash, maiming or killing passengers. You don’t have to go much further than seeing the road toll, or hearing about Malaysian Airlines Flight MH17 shot down over the Ukraine, or watching the TV scenes of the Costa Concordia, run aground just off Isola del Giglio near the coast of Italy, to appreciate that death is never far away.
Then there’s infectious diseases. You can all-too-readily catch a cold, or the flu, or TB, or lately, the Ebola virus. And there seem to be never-ending wars and skirmishes in the Middle East; and terror, spread by fundamentalists.
Each of these, depending on fate, can hasten someone’s demise. Wrong place, wrong time, wrong circumstances.
Lifestyle issues can cause problems for your risk profile too—but these are slower, and more stealthy. Think of smoking, drinking too much, eating yourself into a coma or just gross obesity, or the more insidious dangers of sitting at a computer for years on end with little exercise. These can translate over time into heart or lung disease, diabetes, and cancer.
Whether you are active or passive, things you do or don’t do can shorten your lifespan, or kill you a little or a lot faster than you would otherwise last. So what levels of risk do you actually, quantitatively, face in your own life?
*****
Stanford University decision scientist Ron Howard in the 1970s presented a novel way to calculate this risk. He introduced the idea of the micromort, defined as a one-in-a-million likelihood of death. This is such an evocative unit of measurement that it deserves a little further attention.
If you live in the US or another relatively rich, OECD-style country, with good law and order, legislation that keeps society relatively risk free (such as with environmental and public health issues sorted out, effective building codes, and so forth), a well-educated population, access to health care, and a buoyant GDP, you can expect a micromort of one on any particular day. Another way of saying this is that’s the standard expected death rate for any individual today in any one 24 hour period: a microprobability of one in a million is your index of baseline risk.
These are great odds for you, today, as you read this; you are very likely to get through it. Congratulations if you do.
What circumstances lead to an elevated risk? Say if you do dangerous things or even just live life to the full? How does your micromort level get upgraded?
In the United States, you accumulate an extra 16 micromorts each time you ride a motorcycle 100 miles, for instance. Or 0.7 micromorts are added for each day you go skiing; so go for a week and you’ve added five more.
Or you might decide to do something a little more strenuous. With hangliding, the additional risk of dying equates to eight micromorts per flight; or skydiving, nine per freefall.
They are relatively benign compared to moving up to base-jumping. Do so, and you rapidly earn many more risk points: 430 micromorts per jump, in fact.
Marathon running, anyone? That will be seven micromorts to your debit account for each run. Even walking 17 miles adds one micromort, as does a 230 mile car trip, and add another one for every 6,000 mile train trip. But the puzzle is, it’s not always clear how to treat these: the walking introduces an element of risk (you could be out and about and get run over, or be struck by lightning) but it’s also beneficial (it contributes to improved health).
Perhaps even more interesting, there are microprobabilities associated with accumulated chronic risks in contrast to these other single-shot event risks. These are lifestyle choices and behaviors that incrementally add a little more risk through exposure. They won’t kill you if you have bad luck on a given day, but will slowly have an effect—and may claim you in the end.
Every half a liter of wine exposes you to a micromort because it can accrue into cirrhosis of the liver. Each one and a half cigarettes does the same, but the menace here is cancer or heart disease. Even eating 100 char-broiled steaks, 40 tablespoons of peanut butter or 1,000 bananas sneaks up on you in the form, respectively, of cancer risk from benzopyrene, liver cancer risk from aflatoxin B or cancer risk from radioactive potassium-40.
*****
Hang on though. I doubt I’ve done much to help anyone.
Because a clear problem is that people aren’t very good at doing these kinds of statistics, or applying them to their own lives—and are even less capable of acting on them. We can readily appreciate that skiing or motorcycling add some risk for the time you are doing them compared to the everyday activities of being at work or hanging out at home, yet many people are undeterred. People even cheerfully find ways of taking on more risk, such as by climbing Everest, driving fast cars, or having unsafe sex.
Everyone knows about that steadily accumulated risk, too: not too many of us are blind to the fact that drinking too much alcohol can lead to liver disease or smoking to lung cancer over time. And although both have been falling for decades, this hasn’t stopped millions of people indulging. There’s 42.1 million US smokers at last count, or 18.1% of the population, and on average each adult US citizen consumes 8.6 liters of alcohol annually.
This is not the best performance internationally but is by no means high by international standards, and Eastern Europeans smoke more heavily, and really give hard booze like vodka a nudge. Nevertheless, both activities contribute to what public health people quaintly call excess deaths and the rest of us know by “their drinking or smoking (or both) killed them eventually.”
But what does it actually mean that you expose yourself to increased risk if you go out walking regularly or eat bananas? We need another way of looking at this, because it’s too hard to do the sums.
*****
Enter the University of Cambridge medical statistician David Spiegelhalter and his colleague Alejandro Leiva who invented the idea of a microlife. This is another unit of risk which has the calculation built in for you. It is half an hour of your life.
If you increase your risk by one micromort, then this shortens your life by half an hour. These calculations apply to people on average, and work out for entire populations, but any one of us might be lucky or unlucky, depending on our individual characteristics. Any particular risk doesn’t convert exactly to the specific individual. But with enough people in the US (beyond 316 million now) and on the planet (7 billion and rising), there’s a relentlessness accuracy about the statistics.
So now let’s do some life expectancy math with Spiegelhalter. Smoke a pack a day? You lose up to five hours a day. Accumulated, that’s up to eight years off your life. Have six drinks a day and that binge costs you one half hour allocation—a shortened life by ten months or so. Stay eleven pounds overweight and you sacrifice half an hour every day you do so (another ten months across your lifespan), as you do if you watch TV for two hours. Your coffee habit at 2-3 cups daily takes away another half hour lot. So does every portion of red meat each day. Another ten months each time.
It’s not all negative. There’s good news. Eat five serves of fruit and vegetables every day and you gain up to a couple of hours each time. You get three years back. Exercise and the first 20 minutes per day earns you a surprising hour (there’s a good investment—a year and a half), and each subsequent 40 minutes adds up to one more half hour bonus to your credit (a bit more work but that seems a pretty good deal, too, to get a ten month return).
If you have a hobby, activity or diet and it’s not been dealt with so far, you can fill in some of the gaps with some good guesstimates. Do you have passive pursuits, akin to watching TV? This is a net deficit. Do you do active, exercise-oriented activities, such as weekly amateur netball, soccer, bowling or basketball—or just walking regularly? Add some lifespan.
These half hour allocations alter somewhat depending on your genetics of course (you can have lucky or unlucky genes) or your socioeconomic status (wealthy people typically live longer than poorer folks) or your gender (women on the whole live longer than men). That said, with this idea you are now able to alter your risk profile by changing your behavior with a tangible, calculable return.
*****
There’s a punchline to this, and it may be already occurring to you as you reflect on your own lifestyle and lifespan. There are a million microlives in fifty seven years of existence. That, for many of us, is roughly the adult allocation.
Let’s call that your life expectancy baseline. We can assume that you have had a reasonably healthy childhood (not so for everyone, of course, but true for many US children, and true for most readers). Then, from that point on, a large part of your healthy adult life is now measureable.
So: come out of your teens, reach your 21st birthday, and as the “jolly good fellow” and “happy birthday to you” songs subside, imagine you then have 57 years to go. That is, you have an allocation of 78 years in total, maybe a little longer, maybe a little shorter.
Yes, all sorts of unexpected things might happen along the way, but to some degree your lifespan is now no longer vague, but quantifiable. The actual life expectancy in the US indeed hovers around this: it’s 79.8 years overall, 77.4 for males and 82.2 for females. (It’s higher in some northern European countries and Japan, but that’s a story for another day).
However, you might be reading this thinking: Yikes. I’m not 21: I’m a bit older than that. In this case, you’ve already used up a proportion of your time left. Console yourself. At least you got through the riskiest stage of all: being a baby, up to one year of age, and childhood, up to six or so, when many things can go wrong.
But have you used what you were given so far, well? Or do you have a fair bit of regret?
To make an obvious point, however, this isn’t Doctor Who. You don’t have a Tardis to go back in time and fix the past. So stop any lamentations. Look forward.
By now, if you’ve come to value more readily each half hour and especially the cumulative effect of your lifestyle choices to date, don’t listen to me preaching. Feel completely empowered. You know what to do and how to alter your own numbers.
Now, all that’s left is to do the math. You’ll have a much clearer picture of your life and potential death than ever before. It’s your move: what’s next?
Further reading
Blastland, Michael and Spiegelhalter, David (2014). The Norm Chronicles: Stories and Numbers About Danger and Death. New York: Basic Books.
Howard, Ronald (1984). On fates comparable to death. Management Science 30 (4): 407–422.
Spiegelhalter, David (2012). Using speed of ageing and “microlives” to communicate the effects of lifetime habits and environment. British Medical Journal 345: e8223.
Spiegelhalter, David (2014). The power of the MicroMort. BJOG: An International Journal of Obstetrics & Gynaecology 121 (6): 662–663.
OSCAR: THE $1.5B STARTUP MAKING HEALTH INSURANCE SUCK LESS
Overview of a disruptive new entrant to the health insurance sector, fully consolidating the service and value chain with technology.
http://www.wired.com/2015/04/oscar-funding/
THIS $1.5B STARTUP IS MAKING HEALTH INSURANCE SUCK LESS
IN LESS THAN two years, Oscar Health, a New York City-based health insurance company, has already amassed 40,000 members, with its member-friendly plans and tech-driven approach. Now, the startup has landed another $145 million round of funding at a $1.5 billion valuation, which will help bring Oscar insurance to other cities across the country by the end of the year.
While $1 billion-plus valuations are commonplace in the tech world these days, Oscar is one of a handful of startups that seems to have truly earned it. Oscar, which launched back in 2013, took on one of the country’s most entrenched and hairy markets—health insurance—and infused it with technology and user-friendly design. Now it’s generating around $200 million a year in revenue, according to CEO and co-founder Mario Schlosser. And that’s only in its existing markets in New York and New Jersey.
Meanwhile, Oscar has set a high bar for other insurance companies, offering members a slew of perks like free televisits, free fitness trackers, free checkups, and cash incentives for getting a flu shot. Now, insurance companies in other markets are beginning to follow Oscar’s lead, meaning the challenge ahead for the Oscar team will be to expand faster than their competitors can rip them off. In an industry like health insurance, where the healthcare landscape can change drastically from state to state, that doesn’t happen overnight.
“We don’t just go into a new geography and put a bunch of banners on the walls,” Schlosser says. “It makes the barriers to entry for anyone attempting this quite daunting, but the good thing for us is, for at least parts of this process, we have the technology to handle it.”
Tying It All Together
Oscar’s founding team initially set out to apply a design-thinking approach to health insurance, which meant improving the user experience for a product that is notoriously user-unfriendly. While the team feels it accomplished its initial goal, they realized that fixing health insurance would take more than cosmetic work. To get there, the Oscar team has built multiple tools of the variety that have become popular in health tech recently, including doctor and drug searches, telemedicine, and fitness tracking. More importantly, however, Oscar’s tools talk to each other, ensuring the information doesn’t get stuck in silos across companies.
Oscar also partners directly with physicians to help them better understand their patients. For instance, Oscar may soon give hospital planners access to data on whether or not patients fill their prescriptions or visit urgent care centers after a hospital stay.
According to Schlosser, it’s this holistic approach to technology that will be the company’s competitive advantage as it scales. “Just fixing the user experience won’t be enough,” he says. “We went to great lengths to create an incredibly close relationship between our technology and physicians.”
Already, Oscar is seeing some promising results from this work. One particularly impressive statistic is the fact that some 60 percent of Oscar members who have bronchitis have used the telemedicine feature to diagnose it and get treatment, according to t he company. Of those cases, 93 percent get resolved over the phone with no need for a follow up visit. “We feel that it’s a nice win-win-win situation,” Schlosser says. “The physician can deliver care in an efficient way. The member loves it because it’s convenient, and frankly, we like it, because oftentimes, those conditions could become worse.”
But while a $1.5 billion valuation may be huge for a two-year-old startup, it’s important to remember that’s pocket change compared to, say, UnitedHealth Group’s $114 billion market cap or even Aetna’s $37.75 billion value. If Oscar’s seemingly overnight success in one of the country’s most competitive cities for health insurance is any indication, it’s clear the company still has lots of room to grow.
SciAm smashing Ornish
Article referred to me by Mauricio Flores at P4Mi. Still think it is a precious position, yet more argument vs discussion. Who is right vs what is right.
http://www.scientificamerican.com/article/why-almost-everything-dean-ornish-says-about-nutrition-is-wrong/
Why Almost Everything Dean Ornish Says about Nutrition Is Wrong
When it comes to good eating habits, protein and fat are not your dietary enemies
Credit: TheBusyBrain/Flickr
What’s more relevant to the discussion is this fact: During the time in which the prevalence of obesity in the U.S. nearly tripled, the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydrates—one of the nutrient groups Ornish says we should eat more of—increased. Could it be that our attempts to reduce fat have in fact been part of the problem? Some scientists think so. “I believe the low-fat message promoted the obesity epidemic,” says Lyn Steffen, a nutritional epidemiologist at the University of Minnesota School of Public Health. That’s in part because when we cut out fat, we began eating foods that were worse for us.
Ornish goes to argue that protein and saturated fat increase the risk of mortality and chronic disease. As evidence for these causal claims, he cites a handful of observational studies. He should know better. These types of studies—which might report that people who eat a lot of animal protein tend to develop higher rates of disease—“only look at association, not causation,” explains Christopher Gardner, a nutrition scientist at the Stanford Prevention Research Center. They should not be used to make claims about cause and effect; doing so is considered by nutrition scientists to be “inappropriate” and “misleading.” The reason: People who eat a lot of animal protein often make other lifestyle choices that increase their disease risk, and although researchers try to make statistical adjustments to control for these “confounding variables,” as they’re called, it’s a very imperfect science. Other large observational studies have found that diets high in fat and protein are not associated with disease and may even protect against it. The point is, it’s possible to cherry-pick observational studies to support almost any nutritional argument.
Randomized controlled clinical trials, although certainly not perfect, are better tools for chipping away at causality, and they suggest that protein and fat don’t deserve to be demonized. In a 2007 clinical trial led by Gardner researchers randomly assigned 311 individuals to four groups: One group was assigned the high-fat, high-protein and low-carbohydrate Atkins diet; the second was assigned Ornish’s very low-fat vegetarian diet, which requires consuming fewer than 10 percent of calories from fat; the third was assigned the Zone diet, which aims for a 40/30/30 percent distribution of carbohydrate, protein and fat; and the fourth was assigned the high-carbohydrate, low–saturated fat LEARN (for: lifestyle, exercise, attitudes, relationships, nutrition) diet. The participants all had trouble adhering to their regimens, but all lost about the same statistically significant amounts of weight, and when compared head to head, the Atkins dieters saw greater improvements in blood pressure and HDL cholesterol than the Ornish dieters did.
The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. (All groups consumed about the same amount of protein.) Protein, too, doesn’t look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not.
The other problem with Ornish’s antiprotein stance is that he lumps all animal proteins together. For instance, he wrote that animal proteins have been associated with higher disease and mortality risks in observational studies. But “Ornish is conflating hot dogs and pepperoni with fresh, unprocessed meats,” says Lydia Bazzano, professor of nutrition and epidemiology at Tulane University School of Public Health and Tropical Medicine, “and there’s a big difference between them.” A 2010 systematic review and meta-analysis of 20 studies found consumption of processed meat was associated with an increased risk of diabetes and heart disease but eating unprocessed red meat was not. A 2014 meta-analysis similarly reported much higher mortality risks associated with processed meat compared with red meat consumption and found no problems associated with white meat. The March 2014 study that Ornish cites as finding “a 75 percent increase in premature deaths from all causes and a 400 percent increase in deaths from cancer and type 2 diabetes among heavy consumers of animal protein under the age of 65,” also did not distinguish between types of animal protein. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) “Whole foods—such as whole grain products and fruits and veggies—are healthy, but I think that dairy products, fish and lean cuts of meat or poultry can also be part of a healthy diet,” Steffen says.
So there’s little evidence to suggest that we need to avoid protein and fat. But what about the claims Ornish makes about the success of his own diet—do they hold up to scrutiny? Not exactly. His famous 1990 Lifestyle Heart trial involved a total of 48 patients with heart disease. Twenty-eight were assigned to his low-fat, plant-based diet and 20 were given usual cardiac care. After one year those following his diet were more likely to see a regression in their atherosclerosis.
But here’s the thing: The patients who followed his diet also quit smoking, started exercising and attended stress management training. The people in the control group were told to do none of these things. It’s hardly surprising that quitting smoking, exercising, reducing stress and dieting—when done together—improves heart health. But fact that the participants were making all of these lifestyle changes means that we cannot make any inferences about the effect of the diet alone.
So when Ornish wrote in his op–ed that “for reversing disease, a whole-foods, plant-based diet seems to be necessary,” he is incorrect. It’s possible that quitting smoking, exercising and stress management, without the dieting, would have had the same effect—but we don’t know; it’s also possible that his diet alone would not reverse heart disease symptoms. Again, we don’t know because his studies have not been designed in a way that can tell us anything about the effect of his diet alone. There’s also another issue to consider: Although Ornish emphasizes that his diet is low in fat and animal protein, it also eliminates refined carbohydrates. If his diet works—and again, we don’t know for sure that it does—is that because it reduces protein or fat or refined carbohydrates?
The point here is not that Ornish’s diet—a low-fat, whole food, plant-based approach—is necessarily bad. It’s almost certainly healthier than the highly processed, refined-carbohydrate-rich diet most Americans consume today. But Ornish’s arguments against protein and fat are weak, simplistic and, in a way, irrelevant. A food or nutrient can be healthy without requiring that all other foods or nutrients be unhealthy. And categorizing entire nutrient groups as “good” or “bad” is facile. “It’s hard to move the science forward when there are so many stakeholders who say ‘this is the right diet and no other one could possibly be right,’” Bazzano says. Plus, discouraging the intake of entire macronutrient groups can backfire. When people dutifully cut down on fat in the 1980s and 1990s, they replaced much of it with high-sugar and high-calorie processed foods (think: Snackwell’s). If we start fearing protein, too, what will we fill our plates with instead? History tells us it’s not going to be spinach.
Meeting with Nate McLemore
Great catch up with Nate McLemore, MD of Columbia Pacific, a private equity vehicle buying/building hospitals and aged care facilities across China, India, Malaysia, Indonesia. Focusing on supporting burgeoning middle class populations with mid-priced offerings.
Interesting conversation around financial rationale for tobacco control. Will refer me on to colleagues at Castlight Health and Venrock VC.
NextGen Managed Care Priorities
http://www.ajmc.com/publications/issue/2015/2015-vol21-n4/Redefining-and-Reaffirming-Managed-Care-for-the-21st-Century
Redefining and Reaffirming Managed Care for the 21st Century
Published Online: April 15, 2015
David Blumenthal, MD, MPP; and David Squires, MA
T he term “managed care” is dangerously close to meaninglessness, and unlike pornography, as famously stated by United States Supreme Court Justice Potter Stewart, we may not even recognize it when we see it. Group Health Cooperative of Puget Sound, Kaiser Permanente, and Geisinger are managed care organizations (MCOs). But so are Medicaid plans that—after taking a cut—pay the clinicians’ fee for service and call it a day. The MCO alphabet soup has come to include HMOs, PPOs, ACOs (MSSP and Pioneer), MA plans, PCMHs, IDNs, IPAs, and who knows what else. The very concept of managed care, with its somewhat paternalistic implication of organizational and/or clinician direction of care, seems to run crosswise of the emergent trend toward patient engagement in and control over the care experience.1
Still, few consumers want care that is completely unmanaged, and clinicians talk every day about the management of their patients’ problems: the management of chronic illness and acute illness, of diabetes and appendicitis, of schizophrenia and depression. The optimal management of care, and the creation of policy and organizational environments that facilitate it, continue to have deep intuitive resonance. It is time to retool the term managed care for the 21st century.
That process should start with a review of the major domains of service that can and should be managed for the benefit of patients, and by addressing the seeming—but not inherent—contradiction between care management and patient engagement and empowerment. These are the tasks we set out to do here.
Benefits Management
Certain types of MCOs serve as both insurer and provider. These organizations have to manage benefits as part of the managed care experience.
Clinical benefits management in this setting covers services whose value is supported by evidence. Based on insights from comparative effectiveness research, benefits management should exclude or discourage the use of services shown to be unsafe, ineffective, inferior to alternatives, or not cost-effective. Financial or nonfinancial incentives can also be developed to help shape patients’ choices, such as cost-sharing schemes to nudge patients toward highly effective services. The area of behavioral economics offers useful insights into how to manage proven benefits most effectively.
Clinical Management
Proper care management involves the application by clinicians and MCOs of a series of clinical strategies and techniques that are likely to result in better-coordinated, cost-effective, patient-responsive, and high-value services. These approaches include:
• proactive management of conditions between visits;
• good information systems with clinical decision support;
• predictive analytics to identify patients most likely to benefit from intervention;
• use of patient registries;
• care teams that include a variety of clinicians;
• strategies to address the nonmedical determinants of health;
• management of patient experience, informed by patient surveys; and
• an emphasis on shared decision making.
Clinical management techniques can be employed in any setting, but are likely to be easier and more successful when supported by an infrastructure that enables collaboration and information-sharing across providers, between patients and providers, and even among patients where appropriate. This infrastructure can be provided by external organizations or developed in-house, but will always need to be tailored to the local contexts.
Patient Engagement
Finally, it is important to broaden the concept of care management to include patients as managers of their care experience. For patients with health problems, self-management (or co-management with a clinician) is a powerful tool. For this reason, patient engagement is the third domain of managed care.
As with clinical management, patient engagement can occur anywhere, but is most likely to succeed when supported by an underlying infrastructure. One area where this infrastructure is rapidly developing is the growing market of consumer-directed health information technology products. Patient portals, for example, allow patients to remotely connect with their clinicians or access their medical records, and OpenNotes developers are experimenting with enabling patients to add to provider records. Important new opportunities are arising for patients to voluntarily augment their health information through apps, smart watches, biosensors, and other innovations coming down the tech pipeline.
Another strategy for empowering patients is to improve transparency—in other words, give them reliable information on quality and cost. Such information is currently mostly unavailable or shielded behind proprietary contracts. Having it available when patients need it and in a form that they can understand is necessary for them to make treatment choices and fully participate in shared decision making.
These and other methods for elevating patients’ agency and decision making are increasingly demanded by patients, and they should be part of the managed care concept for the 21st century.
Author Affiliation: The Commonwealth Fund (DB, DS), New York, NY.
Source of Funding: None.
Author Disclosures: The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff.
Author Information: Concept and design (DB, DS); drafting of the manuscript (DB, DS); critical revision of the manuscript for important intellectual content (DB, DS).
Address correspondence to: David Blumenthal, MD, MPP, The Commonwealth Fund, 1 E 75th St, New York, NY 10021. E-mail: db@cmwf.org.
REFERENCES
1. Binder L. Value-based purchasing versus consumerism: navigating the riptide. American Journal of Accountable Care. 2015;3(1):11-14.
– See more at: http://www.ajmc.com/publications/issue/2015/2015-vol21-n4/Redefining-and-Reaffirming-Managed-Care-for-the-21st-Century#sthash.701lslWB.dpuf