Beginning in 2014, the U.S. will implement the most far-reaching Affordable Care Act provisions. At our latest Skillshare class (see slides below), Malay Gandhi broke down some of its major themes and features; describing the move from a treatment-centered model toward more preventive care and ultimately paying providers for health outcomes—not just health procedures.
Despite gaining a larger customer base through mandated insurance coverage, the power shifts away from insurance companies who may no longer selectively choose customers, profit without limit, or cut off benefits by placing “maximum limits” on plans.
Beginning in 2014, customers should be able to easily compare healthcare plans, (which must provide a certain level of coverage), are guaranteed eligibility, and will have more responsibility for their healthcare choices.
The Affordable Care Act upends entrenched business models of healthcare and fosters opportunities for new visionaries to enter and re-shape the system. With fixed payments for providing services to a population, hospitals and providers are incentivized to invest in prevention, efficiency and minimization of unnecessary procedures and administration. Insurers, now capped on margin, must also find ways to be more efficient. And employers will be forced to sort through the economics of being the primary source of coverage for most Americans. How are some companies embracing and taking advantage of these changes?
Benefitter works with employers to help them navigate healthcare reform.
Clinicast develops data analytics and workflow tools to help at-risk healthcare organizations improve outcomes and lower costs.
Eligible provides consumers with up-to-date insurance coverage information for specific procedures—helping companies comply with a new Affordable Care Act provision for simplifying the administration of healthcare.
Wellframe helps track high risk patients and prevent unnecessary and expensive hospital readmissions.
April 29th was the annual gala dinner for The Society for Women’s Health Research (SWHR), highlighting innovations that incorporate informatics or mobile health technology to advance women’s health. These technological advances encourage women to manage their own health and empower them to communicate more effectively and efficiently with their healthcare providers to improve their quality of life. With Surgeon General Regina Benjamin present, Mia Markey, PhD, The University of Texas at Austin, was recognized for her work in informatics to develop decision support systems for clinical decision making in women’s health, including breast reconstruction post cancer surgery.
Highlights of the evening were the announcement several exciting new programs: the first is a 100K challenge for Alzheimer’s research, the Geoffrey Beene Neurodiscovery challenge. Sponsored by The Geoffrey Beene Foundation, this program is the first open-source challenge to target male/female differences in cognitive decline. The second program highlighted was Fatigues to Fabulous ( F2F). Shockingly, the fastest growing segment of homeless are women from military service. Created to ease military women back into civilian life, F2F helps these returning patriots navigate the health system and trains them in the necessary job skills to succeed at home.
The next SWHR event is: What a Difference an X makes: The state of Women’s Health Research, July 18-19 in DC. SWHR is a non-profit organization based in Washington, DC, widely recognized as the thought leader in promoting research on sex based biological differences in disease, and is dedicated to transforming women’s health through science, advocacy, and education.
Shami Feinglass is the Vice President of Global Medical and Regulatory Affairs at Zimmer.
Healthcare costs are soaring – the US spent ~$2.7 trillion on healthcare in 2011, and it costs over $1 billion to bring a novel drug to market. Yet digital health companies can innovate faster and demonstrate their proof of concept with comparatively little money, which is creating new and exciting opportunities for healthcare entrepreneurs.
I recently sat down with Abhas Gupta, MD a partner at Mohr Davidow Ventures to discuss the opportunity for digital health, changes in medicine, and his advice for entrepreneurs. (Mohr Davidow Ventures is a Limited Partner in the Rock Health Fund).
Here are a few highlights, and the full interview is after the jump:
- Digital health companies – in the eyes of a venture capital investor, are characterized as software-driven, capital-efficient, quick to fail, and able to scale. Investors look for passionate, strategic thinkers when evaluating potential investments.
- The single biggest change in the US healthcare market is the shift in business models from a fee-for-service system to an at-risk system. Simply put, doctors are paid today for the number of lab tests or procedures they perform irrespective of patient need or outcomes. In the future, physicians and healthcare systems will be accountable for managing the health of patients with a fixed sum of money (capitation); therefore, healthcare organizations will bear the financial risk. The most attractive digital health opportunity today is to enable physicians and case managers to identify, track, and manage their potential high-cost patients and prioritize cost-effective interventions thus reducing the level of financial risk.
- Gupta’s advice for first time entrepreneurs is to find a niche where you can directly take on soaring health care costs, familiarize yourself with venture math (the mentality of a VC investor) before pitching, and think about the right investor fit for your venture when you raise money. Continue reading…
Once celebrated as the next big thing in the healthcare world, electronic medical records (EMRs) have a long way to go in terms of physician satisfaction, according to survey data from AmericanEHR Partners released in March at HIMSS 2013.
The findings are based on 4,279 responses to multiple surveys between March 2010 and December 2012 about physician satisfaction with EMRs. Of physicians who participated, 70% are in practices of 10 or fewer doctors and the majority intend to participate in the Meaningful Use program. According to the study, physician disillusionment with EMR systems is growing rapidly:
20% of physicians are very dissatisfied with their EMR overall
The portion of physicians who are very dissatisfied with their EMR’s ability to improve patient care doubled from 10% in 2010 to 20% in 2012.
XX in Health is thrilled to host the third XX Retreat in partnership with Rock Health for the first time on the East Coast. XX Retreat DC will be held on June 2, 2013 at the St. Regis Hotel in Washington, DC. The XX Retreat is a one-day event that brings together an elite group of emerging and experienced female leaders in health care.
Unlike other conferences, the retreat is interactive and participatory, providing an opportunity for women to be open and honest.
Through an interactive agenda of activities and inspirational speakers, attendees will explore how their personal and professional lives interact to shape approaches to leadership.
Want to be involved?
About XX in Health
XX in Health connects and empowers female visionaries to drive change in health care. As the nation’s premier network of entrepreneurs and executives, we host curated events, foster online engagement, and support thought leadership. Learn more at xxinhealth.org.