Population Health Colloquium 2018 Update

As a digital journalist and nurse blogger, I look for events that explore the challenges we face in today’s complex work of healthcare and offer innovative solutions by leading organizations. This March, I had the opportunity to attend the 18th Annual Population Health Colloquium. The event was held March 19-21st in Philadelphia PA. The Conference was coordinated by Dr. David Nash, Dean of the Jefferson College of Population Health, and his team. I have been going to this conference for over 10 years and always find the Colloquium enlightening on the work taking place in the area of Population Health. Click here to watch my opening video with Justin Sorenson. Justin and his team at Forerunner Events have managed this conference year after year and do a great job in meeting the needs of speakers as well as attendees.

As you know, weather can be a challenge and wreak havoc with events in March. This year was no exception and as we approached the start of the conference, a Nor’easter was forecasted to hit the area during the event. As noted in the video, Monday was a beautiful day but the weather deteriorated over the next few days. On Monday evening, I got an email from American Airlines asking me if I wanted to change my flight to depart on Tuesday as they were canceling flights for Wednesday when I was scheduled to leave the conference. I hated to leave the conference after just one day, but I had a commitment later in the week that I did not want to miss, so I change my flight and left early on Tuesday. As I was getting ready to leave, I remembered that in addition to the live event, the Colloquium is covered via a live steam. So before I left for the airport, I was able to get the log-in information needed to connect to the live steam event and was able to watch the sessions on Tuesday as I flew home! I also connected on Wednesday, Although I missed out on the networking and meeting with the exhibitors, I did see many of the sessions that I had checked off on the program! You can view the18th Annual Population Health Colloquium from your home or office. View the agenda and purchase access here.

Here are some of the highlights that I walked away with from the 18th Annual Population Health Colloquium

Day 1 started off with pre-conference sessions that focused on a range of topics that included insights on Value-Based Purchasing, how organizations are driving quality through population health; a multi-disciplinary approach to perceptions of aging and the impact of social determinants on health and healthcare.

Dr. Nash officially opened the Colloquium on Monday afternoon. His opening has become a tradition over the years for the insights he shares as to where we were a year ago and where we are today. This year’s overview was titled Nash’s Dirty Dozen. His list included the following points in no particular order and set the tone for the Colloquium.

“Regrettably and amazingly, more American’s are uninsured today than they were when I stood before you a year ago. Some would argue the nation looks as though on the political front that we have declared a War on the Poor”.
HHS Secretary Dr. Alex Azar and CMS Administrator Seema Verma re-embraced the extricable journey from volume to value. There keynote at HIMSS two weeks ago was telling. You can read about their remarks here. Dr. Nash noted that “the only way out of the challenges the healthcare industry is facing is for those who work in the healthcare industry to move from “volume to value” or in other words, “No outcome – No Income”.
Med Pack publically criticized MACRA calling for a repeal of the only bipartisan bill that supports quality and safety. A real head-scratcher.
We are seeing more and more mergers and acquisitions taking place in healthcare. A few of the new marriages include: CVS buying Aetna, the Cigna and Express Scripts merger and Walmart is eying Humana. Some say these mergers are “the fox, buying the hen house”
As the country looks toward the Midterms election, the recent election of Representative Conor Lamb was telling. In the exit polling, the number ONE issue voters gave for voting for Lamb was to preserve Obama Care! “Maybe there is still some hope for the future!”
The industry is still struggling to develop measures to identify Social Determinants of Health. Jefferson University has two offsite research centers one in Johnston PA and one in Mainline Health to explore the issues surrounding equity in how we how to deliver care.
New Books on the NY Times Best Seller List from Population Health Colleagues include:

Mistreated: Why we think we’re Getting Good Health Care and Why We’re Usually Wrong, by Dr. Robert Pearl. Available at Amazon
Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations by Dr. Ezekiel J. Emanuel. Available at Amazon.
An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Dr. Elizabeth Rosenthal. Available at Amazon.
Editor’s Note: I would like to add a new book just published. The Case Management Guide to Population Health by Mary McLaughlin, President of the Case Management Society of America. Available at HCPro.

More organizations are putting into place Population Health Executives!
The realization that there is a tremendous influx of private equity money coming into Population Health programs. The question has to be asked, what will the influence of all of this money mean to the industry?
Moving from Triple Aim to Quadruple Aim: Recognizing that healers are hurting: Nurses, Pharmacists, and Physicians need to take care of themselves as they are burning out as they try to make sense and keep up in the disruptive healthcare system.
The realization that we a sicker society by every public health and population health measure than we were a year ago. Mortality has gone up, and lifespan is shorter for our kids due to the disease of despair and drug use/abuse.
Last But Not Least…..and my favorite…..Dr. Nash reminded all in attendance that we are sitting in the ‘City of the Champion Philadelphia Eagles’!! Fly Eagles Fly!

Following Dr. Nash’s Opening Remarks, David Shulkin, MD, and Secretary of US Department of Veterans Affairs took the stage.

I have to admit as I was preparing for the conference, I did a quick search to see if the Secretary was still in place as it was rumored that President Trump was thinking of firing him. I was glad to learn he was still in place as the head of the VA and would be speaking! I am glad I was able to hear him speak at the Colloquium. His presentation was impressive, as he gave an overview of the ‘state the VA’ and what he was doing to improve the Veterans Administration so it was meeting the needs of our retired men and women from each branch of the military. Unfortunately, he was fired a few days later, leaving our Veterans in limbo without a leader. The Veterans Health Administration is the largest integrated healthcare system in the United States, providing care at 1,240 healthcare facilities, including 170 VA Medical Centers and 1,061 outpatient sites of care of varying complexity to over 9 million Veterans enrolled in the VA healthcare programs. The VA employs more than 306,000 full-time healthcare professionals and support staff. As you can image, leading this organization is no easy task and will take someone with knowledge and commitment to the military healthcare system and has exceptional organizational, business and leadership skills.

Another interesting session was the Dynamics and Implications of Rural Aging – A Movement for Change. The speakers were, Alan Morgan, CEO of National Rural Health Association and Donato Tramuto, President, and CEO of Tivity Health. Both shared their insights on the aging of America and how their organizations are doing important work to ensure American’s receive safe, quality, cost-effective healthcare services that promote wellness and wellbeing. Rural Healthcare organizations are good examples Urban areas can model. Due to their geographic locations, they have had to do more with less, but despite difficult these obstacles they able to show positive outcomes. Mr. Tramuto organization, Tivity Health, may not be known to the broad public, but one of their products is SilverSneakers, a program promoting wellness to Medicare Advantage beneficiaries. This was interesting to me as I recently became a member of SilverSneakers and was glad to meet the CEO and talk to him for a few minutes about my experience with the program. I hope to keep in touch with him to share ways that came better engage those eligible to use the program in order to improve their health as they age.

The next session was: Journey to Value-Based care – Experience and Expectations. The speaker was Niki Ozment Buchanan. Ms. Ozment Buchanan shared information on how the industry is moving from volume to value and the outcomes those following VBP principles are showing.

The last session of the day was titled: Setting Bold Goals: Addressing Social Determinants of Health to Create More Healthy Days for Patients and Communities, presented by Andrew Renda, MD. Dr. Renda is the Director of Bold Goal (Humana’s Population Health Pilot), Measurement, Insights & Communications, Office of the Chief Medical Officer, Humana. He shared that Social Determinants of Health are key indicators on how populations will do. Understanding the barriers and the roadblocks can help payers and providers implement programs to meet the needs of their populations and prevent costly setbacks due to SDH.

Day 2

For the past three years, the Hearst Health Prize is given out on Day 2. The Hearst Award is awarded to organizations doing excellent work in the area of Population Health. Before introducing the three finalists for 2018, there was a panel discussion with the 2017 winner, Brenda Reiss-Brenna. Brennan is with Intermountain Healthcare who won the 2017 Hearst Award for the focus on Mental Health Integration into Primary Care. Dr. Nash, Dr. Mark Smith and Dr. Mark Dorn and Ms. Reiss-Brenna talked about the challenges in implementing mental health programs into primary care practice. The the main barrier found in the primary care setting was addressing the stigma of mental health issues. The Intermountain Mental Health Integration program focused on normalizing the discussion of mental health challenges as part of the primary care doctor was key to addressing issues. Having a mental health professional as part of the care team helped to improve outcomes for those with medical as well as behavioral health issues. Over the years,

Next, Dr. Nash and Dr. Mark Dorn announced the finalists for the 2018 Hearst Health Prize. They were:

The winner of the 2018 Hearst Health Award is Massachusetts Housing and Shelter Alliance. They received a check for $100,000.00 to further their work in addressing social determinants of health and population health.

The next two speakers were a treat for me as they both are national leaders who have been involved in healthcare for as long as I can remember. First up was Michael Leavitt, Founder and Chairman, Leavitt Partners; Former Secretary, US Department of Health and Services and Former Governor of Utah. Dr. Leavitt talked about the importance of ensuring all providers and organizations are accountable for the care they provide. He and Mark McClellan have teamed up and developed the Account Care Learning Collaborative. The Collaborative goal is to educate all members of the healthcare team, payers, and stakeholders on Accountable Care principles and strategies. Secretary Leavitt reminded all that in order to have a stable healthcare there needs to be stability in three main areas; cost, quality, and access. Today, the economic imperative is driving healthcare. What we are seeing today is that quality is diminishing, the cost of healthcare is decimating the country and due to rising costs, access is limited to those who can’t pay. Secretary Leavitt put out a call to volunteer your time as part of the accountable care collaborative. Sign up today.

Next was Tommy Thompson, the Former Secretary, US Department of Health and Human Services; Former Governor of Wisconsin and Chairmen, 4C Health Solutions. He shared that over the past few years, all stakeholders have been working to learn how to use data to improve care. We have made improvements, but are still way behind other industries. His remarks focused on the importance of putting strategies into place that can address/reduce fraud and abuse in the broad healthcare system. Today, fraud, abuse, and waste cost the system around $80 billion a year across all lines of insurance. Today, there are tools that if implemented can catch and reduce fraud, but we have yet to implement them. 4C Health Solutions is one toll that might be worth checking out.

After these two leaders spoke, they sat down with Dr. Nash and shared their thoughts on where we are today and where we have to go.

Some key takeaways:

Consumers have a right to know what the cost of their care is before it happens
A change will come from the bottom up. We all need to use our knowledge, techniques, independence to change the system
Status quo is our biggest enemy.
Transparency looks at the work we are doing and how it impacts patients, outcomes and how we can deliver care better.
Need to be prepared for today, and work towards tomorrow
Save the system, save the republic. We all need to learn a new way of delivering care.

Day 3: The last keynote spear was Darryl Strawberry, Sr! Those of you who follow baseball will remember Strawberry as a major league baseball player. He is now retired and on a speaking/book tour about his drug addiction experience. His message was clear, that those who fall prey to drug addiction need kindness and for all caring for them to know they are broken. They will not heal till they work through their loneliness/brokenness. He has a new book on the subject that anyone who is living with the disease of addiction should read. The book is called Don’t Give Up on Me: Shedding Light on Addiction.

The closing panel moderated by Dr. Nash is always a good way to end the Summit. This year’s panelists were:

Evan Benjamin, MD, MS. Chief Medical Officer, Ariadne Labs, Professor of Medicine, Tufts University School of Medicine
Brent James, MD, Senior Advisor, Leavitt Partners; Former Chief Quality Officer and Executive Director, Institute for Health Care Delivery Research, Intermountain Healthcare.
Mikki Nasch, VP Business Development, Evidation Health, Inc.
Rita Numerof, PhD Numerof & Associates, Inc.
Daryl Strawberry, Sr. Former Professional Baseball Players, Ordained Christian Minister and Author.

The panel provided closing remarks that country is in a disruptive state and will remain this way for the near future. All stakeholders need to be involved in working to improve the delivery of care. Patients, caregivers, providers, and payers all need to work together without this collaboration, change cannot occur. The patient has to be included as a key member of the healthcare team and we all need to be kind to each other. As noted above, changes will come from the bottom up and value-based purchasing is here to stay.

If this overview piqued your interest in the 18^th Annual Population Health Conference, consider purchasing the webcast so you and your team can hear all of the sessions. Listening on demand is a great way to be up to date on what is happening in the world of population health. This is a critical time in our country, and it will take our collective efforts to address the issues that threaten our economy due to rising healthcare costs.

If you are doing good work in the area of population health, think about doing a presentation for the 19^th Annual Population Health Colloquium. The dates for next year are March 18-20, 2019 at the Loews Hotel in Philadelphia. Bookmark the website so you can keep an eye out for the calls for presentations and are aware of the updates as they come out.

Another way to share your work is by submitting an entry into the 2019 Hearst Health Awhttp://www.hearst.com/newsroom/hearst-health-jefferson-school-of-population-health-introduce-the-hearst-health-prizeards. Watch for the call for submissions for the 2019 Awards!

Thanks for reading my Blog, Nurse Advocate and I look forward to seeing you at another healthcare conference! To see where I will be, check out my website!