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Health Plans Receptive, But Not Ready for Change

Jacqueline Fellows, for HealthLeaders Media, July 9, 2013

HLM: What were your expectations?

Phillips: My hope was that we could do two things. One, that we could have an atmosphere where the payer, provider, and financing structure of healthcare could come together to have an open dialogue without looking at each other like we have fangs, and they (Nashville Health Care Council) did that. The other thing I hoped to get out of it was learning new things that are coming down the path that can be game changers for the entire market.

HLM: What are those game changing elements?

Phillips: There are technology [examples] that can disrupt our market and force change. A specific example of that are the technologies that are available to monitor conditions in a completely mobile space. You can essentially use a sensor and deploy a network of other sensors to read conditions.

In-home care could be completely altered in the next five years, or how that technology can be distributed in a telehealth network that can completely change the face of primary care. Things like that have a way of forcing the market to wake up because they are game changers.

HLM: Changing how care is delivered will mean a change in how insurance companies pay for that care. How receptive is your industry to embracing these sorts of new technologies that can force that change?

Phillips: I think the industry is very receptive. The pressure to change is on us too, and not just on the premium side of the equation. The challenge is that the payer system is slower to change in some ways than the provider community. 

You're talking about massive organizations that have heavy information technology infrastructures that are hard to move on a dime. Our challenge will be to keep pace and improve scalability and return on investment as fast as possible. So, I think the industry is receptive; I don't think the industry is prepared for it.

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