Aging in the Age of Disruption
On May 4, EmblemHealth CEO Karen Ignagni participated in a panel discussion on the changing landscape of health insurance at the second annual d.health Summit. Hosted at the New York Academy of Science, this year’s summit brought together health care leaders, policymakers and startups to examine technology-enabled solutions and strategies for improving the health of the aging U.S. population.
1. Personalizing health care
“The name of the game in health care right now is not only cost, performance and quality, but patient experience,” Ignagni explained. “The new model is here-and-now, on-demand care, and EmblemHealth is making sure that this is not just rhetoric, but actionable and personalized.” She outlined three key questions that insurance consumers ask when choosing a health plan. The first centers on individual or household needs and finances: Do they need a high-deductible or comprehensive plan? Second, what hospitals or clinicians are in-network? The third is how they will access health care when they need it, whether it’s a routine check-up or a medical emergency at 2 am. “We’re personalizing a system that historically hasn’t been personalized,” Ignagni concluded.
Personalized care that is retail instead of wholesale, as Ignagni described it, is the path forward in the “aging in place” market. The ability to “age in place” — defined by the Centers for Disease Control and Prevention (CDC) as “living in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level” — is a key need for seniors in today’s insurance landscape. In a panel on home care and investment, Stephanie Tilenius Founder and CEO, Vida Health and Owen Tripp CEO, Grand Rounds, listed the three biggest challenges to “aging in place” as inertia, entrenchment and a lack of personalized solutions that are designed with compassion and a patient’s unique needs in mind.
2. Organizations are establishing blueprints for success at the community level
“The communities that we serve need help, and that’s part of our responsibility as a nonprofit plan,” said Ignagni. She cited EmblemHealth Neighborhood Care — four brick-and-mortar locations that provide culturally competent health care solutions — as one example of how EmblemHealth “walks the walk,” often in areas of New York City that are health care deserts and have larger underserved communities.
Shelley Lyford, CEO and President, West Health and Bas Bloem, Medical Director, Parkinson Centre Nijmegen echoed Ignagni’s remarks in a separate panel on successful aging and chronic care. “Many innovators like to innovate, and once they’re done, they move on to something new,” Bloem said. “Our partnership with Kaiser forced them to write down their ‘cookbook’ so they could take it elsewhere within their organization.” Similarly, added Lyford, West Health’s San Diego-based senior centers serve as “blueprints for community models,” as opposed to proprietary best practices.
3. Family caregivers are key players
Each year, more than 65 million Americans provide unpaid care for a chronically ill, disabled or elderly family member or friend. As the “hidden patient” in U.S. health care, Steven Landers CEO, VNA Health Group, argued that, “we should be looking seriously at adding standard measurements of caregiver outcomes and experience. Reporting on Medicare patient experience has brought satisfaction to the forefront; measurement can be a great policy tool to motivate change.” Ignagni pointed to EmblemHealth’s Care for the Family Caregiver initiative, launched in 2001 to help caregivers manage daily challenges and improve their overall health and wellness, as an example of how organizations can improve the caregiver experience at the community level. At the policy level, Bloem added, by focusing on outcomes, “value-based care embraces the value of caregivers.”
4. Value-based payment reform is driving innovation
Referencing EmblemHealth’s partnership with Northwell Health and other value-based relationships, Ignagni noted that, “value-based care is not going to push the envelope or create enduring change if payment reforms are upside-only. Providers, clinicians and hospitals assume risk and are responsible if they don’t hit certain markers.”
Citing his experience in the U.S. and the Netherlands, Bloem argued that the traditional fee-for-service payment model is stifling innovation in both countries. Value-based care proposes a “fee-for-outcome” model, which fosters transparency between payers and providers, he explained. “Transparency enables health care organizations to innovate by learning from our differences.”