Health plans can contribute to healthcare reform by reorienting financial incentives for value over volume and reward high-value technology creation that reduces morbidity, mortality and total spending over a lifetime, said panelists at AHIP Institute 2009.
Health plans have a lot of the components to be able to drive meaningful use of healthcare IT, said Jeremy Nobel, MD, adjunct lecturer of health policy and management at the Harvard School of Public Health.
Health plans have the data, the IT infrastructure, key relationships with both providers and members, and can manage business models around such things as benefit design and pay for performance, he said.
Nobel and other experts spoke at a session called “Examining the External Forces of Change: Realigning Your IT Strategy to Do More with Less.”
“We desperately need innovation in healthcare and in a variety of ways,” said Charles Kennedy, MD, vice president of Health Information Technology for WellPoint. He stressed that the concept of the advanced medical home can only reach its potential through healthcare IT, the reorganization of how care is delivered and how patients, physicians and other caregivers communicate.
Harry Reynolds, Jr., vice president and information compliance officer for Blue Cross and Blue Shield of North Carolina, challenged health plans to get involved, collaborate and share the infrastructure.
Health plans can support healthcare IT to improve population health and lower cost, said Robert Mandel, MD, senior vice president of healthcare services for BlueCross BlueShield of Tennessee. They have the opportunity to implement the technology and create incentives for providers to implement electronic health records, e-prescribing and so on, he said.
“We have lowered our costs and physicians are engaged in the technology,” Mandel said.
Health plans need to help change people’s behaviors, said Paul Thompson, vice president of product development for CIGNA Healthcare. Web-based applications can be an enabler, he said.
Thompson noted that the key challenge for health plans is to be able to build and manage innovation and healthcare IT. He suggested health plans find key partners for innovation.
Kennedy concluded that health plans have more experience than anybody else in the industry using claim data for clinical purposes.
“We have to increase the understanding of clinical use with claims data,” Thompson said.
