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Economy and New President Shape This Year's Top Ten Issues Facing Managed Care Executives

CLEVELAND, March 24 /PRNewswire/ -- Dealing with a difficult economy and a new administration in the White House are the overall themes of the Managed Care Executive Group's (MCEG) annual meeting held in Chandler, AZ last week. The themes shape the definitive Top Ten issues list the group produces each year. Despite economic challenges, this year's Top Ten list is hopeful of strategic positives funded by the federal stimulus package that could accelerate advances, such as solving the affordability issue and improving electronic collaboration.

This year's MCEG Top 10:

  1. The Role of State and Federal Government in Health Care: Government support, intervention and regulation are having increasing impact on payer's operations, costs and even marketplace strategies. The importance of electronic health information technology in reforming the U.S. healthcare system is evident in the President's health care plan. Funding of HIT will accelerate adoption but with funding will come increased regulation, oversight and compliance audits. This will impact IT budgets, operations and project planning.
  2. Affordability: Looking for ways to contain costs, and given that most operations have been pretty well optimized, plans will tend to look for more creative plan designs and provider risk sharing. Cost pressures will facilitate the continued trend toward consolidations of payers.
  3. The Stimulus Package and HIT: $20 billion or more directed to healthcare IT will establish a revised set of priorities for health plans and their IT leadership.
  4. Collaboration with Providers as a Business Partnership: Recently, partnership has been based on access, quality, safety, effectiveness and patient centeredness. P4P is holding providers accountable, stressing bridges to excellence. Now, partnership in innovation is taking such forms as retail clinics, primary care automation, medical imaging management and practice guideline development.
  5. Data analytics and informatics: Disease management, real-time decision support, case management, customer segmentation, and protocol development will continue to drive investment in analytics. Clinical information will be broad and deep, enabling caregivers to more precisely identify diagnoses and target treatment.
  6. Impact of Recession: Combined effects of economic recession, pressure on Federal and State budgets, and the perception of a healthcare "cost bubble" will force an end to decades of cost inflation. Health care insurance premiums will decline beginning in 2010.
  7. Providing transparency to health plan data and operations: The ability to allow providers and health plans to utilize shared data continues to expand. The need to improve patient outcomes and operational efficiency is leading to investments in quality measurement, peer-grouping, provider report cards and predictive modeling.
  8. Health Data Exchanges: RHIOs (Regional Health Information Organizations) and data exchanges are moving from concept to reality. Some basic issues in finding sustainable business models include: ownership, architecture, technology standards, patient privacy/security, and establishing trust.
  9. Consumers, the Web and Health 2.0: Self-service, personal health records, individual product fulfillment, coordination of care, transmission of home monitoring data, and telephone or even live video e-visits with caregivers are examples of new technologies needed to bring consumerism to healthcare.
  10. Business and IT Collaboration: In times of change, the importance of a strong business/IT partnership is heightened. Business and IT leaders are collaborating to re-engineer business processes, increase speed and improve customer experience.

SOURCE Managed Care Executive Group
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