The Medicare Management Balance Beam
This panel discussion featured industry leaders discussing key issues in Medicare, emphasizing the need for achieving balance in Medicare management. The discussion was centered on several critical points:
1. The growth of Medicare Advantage: Currently, about 51% of Medicare beneficiaries are enrolled in Medicare Advantage, with more beneficiaries joining Accountable Care Organizations.
2. Emphasis on Partnerships: The panelists stressed the importance of partnering with other organizations to improve health outcomes for seniors. They believe that no organization can do it alone and that achieving success and balance might require acquisitions or partnerships.
3. Role of Technology: The panelists noted the growing acceptance and use of digital applications and text messaging among seniors. Creating a super app for healthcare that connects benefits, care delivery, and retail was seen as a foreseeable future development.
4. Clinical Integrity, Data, and Scale: To engage with large organizations, start-ups should maintain clinical integrity, have rigorous analytical plans, and demonstrate the ability to scale their operations across multiple markets.
5. Personalization of Healthcare: The future of healthcare lies in individualized care plans facilitated by technology. Specific interventions are necessary based on the patient's needs.
6. Importance of a Care Model: A care model based on a team is integral for providing efficient healthcare. A positive culture in caregiving is necessary and organizations should aim to be the employer of choice for providers.
7. The Value of High-Quality Care: Value-based care is about providing high-quality care. The panel argued that good doctors who stay up-to-date and care about their patients are already providing value-based care.
8. Challenges of a Multi-Payer Environment: Technology can be beneficial in managing care across a diverse payer environment. Using data and technology to understand the needs of the patient coming in that day was seen as a critical aspect of this management.
9. Medications: The most common interaction in healthcare was considered to be the delivery of medication. Plans that facilitate patients in getting all these benefits which they qualify for were viewed as an important part of their care.
10. Social determinants of health: The role of social factors in health, such as access to the internet or graduation rates, were highlighted, emphasizing the importance of holistic, whole-population approaches to healthcare.