Tea Buzz

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Feb
12

Easing Concerns Around Claims Data

Recently, an article was released detailing a lawsuit brought against Via Christi Health, claiming they defrauded Medicare and engaged in a scheme to maximize Medicare reimbursements through their cardiac referral program. According to Becker’s Hospital Review and KCUR.org, part of the complaint alleges, “that Via Christi has a bonus program that it uses to incentivize physicians to make referrals to its hospitals.”

The case has raised concerns about referral patterns and how those are affected by claims data with CFOs across the country, and has created a less-than-positive buzz around using data to help drive referrals.

Tea Leaves Health’s Physicianology™ solution (and most other physician referral management solutions in the healthcare industry) digests claims data to help our users understand whether physicians are referring to specialists within their organization, or to specialists outside of it. The intention is to provide insights to hospitals and health systems so they can understand the referral patterns of their physicians and maintain volume within their systems. It is never to encourage providers to refer patients to other organizations for unnecessary procedures.

Our clients, and all healthcare organizations, take the care of their patients very seriously. They use the data to build partnerships to provide the best possible, seamless care. Physicians referring to specialists is a common component of the healthcare continuum, and it’s important that both patients and primary care providers have information about the specialists in their network – so they can make informed decisions – which is what this data provides.

To ease concerns around the use of claims data within our databases, we want to make it known that Tea Leaves Health very purposefully does not tie any financial information to our claims-based data, and we never use any patient-identified claims-based data. The claims data we receive for our users is absolutely HIPAA/PHI compliant.

The success of healthcare organizations across the country is dependent on data – on using that data to provide answers to questions, resolve challenges, make predictions and sustain growth in an ever-evolving landscape. It is our hope that this case does not deter organizations from using data to better understand its business.

If you or anyone at your organization has further questions around how claims data is used in the referral process, feel free to contact our experts who can help shed further light on its uses and results.


Feb
08

What the Amazon, Berkshire Hathaway, JPMorgan deal means for payers

Healthcare Finance News – Susan Morse

The potential ability to lower the cost and target insured employees in a personalized, digital way has many in the sector taking notice.

The announcement of the healthcare partnership between Amazon, Berkshire Hathaway and JPMorgan Chase is either the major disruptor everyone in the industry has been awaiting or means little except to the three companies involved.

Since the firms have given no indication of what they’re planning, everyone is reading into the collaboration.

Reaction has been like a Rorschach test, Kaiser Health News Chief Washington correspondent Julie Rovner said during an America’s Health Insurance Plans forum Tuesday morning.

People in the industry are either excited or scared.

“They’re focused on managing cost, also on that patient or employee experience,” said Tracy Watts, a senior partner with Mercer, during Tuesday’s AHIP panel discussion on employer insurance coverage. “Think about how the experience on Amazon is different than how we access healthcare delivery. I look forward to what they come up with. I don’t know if it will be dramatically different.”

The Adis Group CEO Lyndean Brick said the whole thing is a mixed bag.

“Some are excited and others think it doesn’t mean anything. I think it’s reasonable to think that payers have to pay attention to this,” Brick added. “There’s the theoretical possibility that this could take insurers out of the system.”

Payers welcome this as an opportunity, according to Miki Kapoor, president and former CEO of the Tea Leaves Health division, which was recently acquired by Welltok.

“Payers are saying ‘it’s a jolt that was needed.’ I believe payers know there is always going to be a role for them. They want to evolve so they remain at the center of care.”

Many in the industry believe Amazon, Berkshire Hathaway and JPMorgan Chase will cut out the insurance middleman for coverage for their combined 1 million-plus employees.

Shares of Anthem, Cigna, UnitedHealth Group, Humana, Aetna and Aetna’s potential buyer, CVS Health, along with pharmacy benefit manager Express Scripts, tumbled after the Jan. 30 announcement, before the stock market took a general steep drop on Monday.

Analysts have viewed the $69 billion merger between Aetna and CVS Health as a preemptive strike against what many believed would be an announcement by Amazon that it would enter the pharmacy services business.

Toby Cosgrove, former CEO of the Cleveland Clinic who now serves as an executive advisor, said during a precision medicine conference this fall that the industry was concerned about major forces in the supply chain, notably “Amazon coming at us in purchasing.”

HIMSS CEO Hal Wolf said that, even short of details at this point, the fact that Amazon, Berkshire Hathaway and JPMorgan have come together to address employer-related healthcare is intriguing.

“Depending on how this new idea gets positioned and where they go with it, the company could have an impact on a lot of health systems that have their revenue driven by payments in this same space,” Wolf said. “That’s why they have to hurry up and get faster with digital health.”

Wolf also said that he anticipates more companies outside healthcare moving to disrupt the industry in interesting ways.

“I don’t expect it to slow down,” Wolf said. “I think we’ll see more and more combinations in the future.”

JPMorgan Chief Executive James Dimon publicly tried to calm fears, saying the deal would only serve the employees of the three firms, according to The Wall Street Journal.

But JPMorgan also confirmed that it welcomes others to get involved after JPMorgan spokesman Brian Marchiony said in the same WSJ report that the bank has “had hundreds of phone calls and emails from client CEOs, doctors and healthcare administrators looking to see how they can get involved.”

On a Thursday earnings call, Cigna CEO David Cordani said the deal is “presenting more opportunities than not.”

Cordani talked about the importance of its U.S. commercial employer business as a “very attractive growth opportunity.”

Should the Amazon partnership go in the direction of taking a million-plus lives out of the commercial insurance market, and should it welcome others to get involved, insurers could find they’re covering more higher risk beneficiaries.

Cordani indicated that Cigna has been thinking for some time about the future direction of the health insurance industry, and it’s not the same old model.

“Clearly the announcement was not lost on us,” Cordani said during the call in response to an analyst question on the Amazon call. “So stepping back I think one way we look at the announcement is, it reinforces something we’ve been talking about for quite some time, which is – it’s a pretty dynamic industry and the older orientation around focusing only on insurance or a fee-for-service healthcare delivery model is just fundamentally not sustainable as employers and customers demand more.”

That reinforces the imperative of focusing on transparency, alignment and a demonstrable way to drive healthy productive present employees and making the employer’s business better and more effective, he said.

The main threat, or opportunity, presented by the Amazon deal is the ability of the online giant, backed by data and funding, to fundamentally lower the cost of healthcare, and to target insured employees in a personalized, digital way, better and more effectively than traditional providers and insurers.

“If I bought books on Amazon two years ago, they still know what I like and need. I think Amazon is around changing the dynamic,” Pfizer CMO Freda Lewis-Hall, MD, said at the same precision medicine summit attended by Cosgrove.

She likened the industry’s efforts to delivering Star Wars advancement in a Flintstones’ system.


Amazon, JPMorgan and Berkshire Hathaway, however, will have the ability to manage employees as patients outside of the four walls of the healthcare system, Kapoor said. They will be able to influence behavior and measure those choices.

But the bottom line is that they chose to do this because they became frustrated with the cost of healthcare, he said. 

“Healthcare is breaking our economy,” Kapoor said. “I think these titans of industry have said, ‘we’re going to do something about it.'” 


Brick said, “They’ve acknowledged they’d have to bend the cost curve. The way to bend it is to take out the middleman. They have the infrastructure. They can have their own little ecosystem, have Amazon deliver drugs to a person’s doorstep. They can buy providers.”

The present system is regulated and fragmented to the point that it can’t really innovate, she said.

“If we can innovate in an ecosystem like this, I think there may be some good examples that come out of this that are able to be adopted by the rest of healthcare,” Brick said. “I’m excited about this. It’s a public acknowledgment that employers are going to take charge and try and fix the system.”

 


Originally published here:

http://www.healthcarefinancenews.com/news/what-amazon-berkshire-hathaway-jp-morgan-deal-means-payers


Feb
05

Physician Liaison Team Reverses Cardiothoracic Leakage

A hospital system was experiencing leakage out of their Cardiology program; particularly in the area of Cardiothoracic. One of their competitors was aggressively targeting their heart surgery patients and in the last quarter did six surgeries from their primary zip code. The quarter before that, they hadn’t done any surgeries. The hospital’s physician liaison team needed to find out which surgeon(s) were doing open heart surgeries at the competitor and who was referring to them. They needed to know where the referral leakage was coming from in order to slow the rapid pace of workload going to the competitor.

The hospital team turned to the experts at Tea Leaves Health and the Physicianology™ application to mine this information. Using the Splitter Details Report in the application, the teams identified five thoracic surgeons with cardiovascular workload at the competitor.

  1. N: 100% of his workload
  2. S: 22% of his workload
  3. A: Less than 10 patients
  4. J: Less than 10 patients
  5. B: Less than 10 patients

The Physicianology team quickly added these physicians to a list, so they could monitor their progress with the accompanying dashboards in the application.

In the meantime, the hospital’s liaison team created Action Plans to work with these five physicians to keep the surgeries within their system.

After six months, the Physicianology team analyzed the progress, and saw that Drs. N and S were two of the hospital’s top gaining physicians, meaning they were beginning to keep more workload within the hospital. At the time this report was pulled, Dr. N had performed 10 surgeries in the system; four over the previous month, and Dr. S had completed eight surgeries; one over the previous month.


Jan
29

The True Value of Unlimited Support

If your hospital is in the process of selecting a new CRM or PRM vendor, and you’re at the stage of contract redlines, what are you finding? No obligation to provide additional support as needed? All maintenance and technical support for your users will be your responsibility after implementation? Out-of-pocket expenses, like the costs of travel to your facility for training, will be billed back to you afterwards?

Perhaps the vendors you’re vetting are only promising you a set amount of account management hours. Anything above and beyond that will undoubtedly require a revised estimate with a hefty fee. And if you don’t use the support hours in the first year, can they be carried over into subsequent years? Probably not. Some vendors may charge you an additional rate per hour for any hours exceeding the agreed upon amount.

But what happens when their application doesn’t live up to expectations, and the account management hours you thought you’d need run out in the first few months of the contract? How much will you be willing to spend to get the support you need?

At Tea Leaves Health, our clients receive an unlimited amount of support. No extra costs, no additional fees for hours or travel or support. NONE. But what does that truly mean, exactly? How do you quantify the worth of unlimited?

We’ve determined that the grand total of unlimited support for a three-year contract is valued at roughly $368,640.

And what does unlimited support include, exactly?
Access to our Client Services team at any time (during work hours) for the following:

  • Strategy Planning
  • Online Trainings
  • Running Reports
  • Running Queries
  • Checking Counts
  • Bi-weekly Check-in Calls
  • Presentations to Executive Leadership
  • Onsite Strategy Sessions
  • Educational Sessions (Lunch and Learn offerings)
  • Ordering Campaigns
  • Reviewing Invoices
  • The list goes on and on.

The Tea Leaves Health One Platform is the most intuitive and user-friendly in the industry, so most clients don’t require a lot of support. However, if our clients need assistance with anything, we’re there. We offer the strongest, most knowledgeable client support team on the market, who are available to help as needed without any additional fees.


Contact us to start your consumer and physician engagement journey today.


 

For a detailed breakdown of how we calculated the value of unlimited support:

download “The True Value of Unlimited Support” here.

 


Jan
25

Tea Leaves Health Significantly Increases Patient and Referral Volume for Leading Integrated Health System

Organization Leverages Big Data to Identify and Engage Patients Overdue for Preventative and Specialty Support Services

ROSWELL, Ga., Jan. 25, 2018 /PRNewswire/ — Tea Leaves Health, a Welltok company and leading provider of a SaaS-based analytics and marketing technology platform, announced today the success of two targeted outreach programs for a northeastern, not-for-profit health system. The nationally-recognized health system, which includes four accredited, acute-care and specialty hospitals, tapped Tea Leaves Health to help increase prevention and specialty support within its communities. The campaigns drove record-numbers of new patients for preventative mammogram screenings, and increased visits to its specialty urology practice by 97 percent.

“Consistent with leading hospital and health systems across the nation, our client’s focus has expanded to provide whole health support and engage with individuals in its communities before they are sick,” said Miki Kapoor, president of Tea Leaves Health. “Our CRM and PRM platforms developed measurable and successful growth initiatives for the integrated health system, and more importantly, increased its ability to serve more people with award-winning care and services.”

Patientology, Tea Leaves Health’s customer relationship management (CRM) platform, leveraged big data and analytics to help the integrated health system better understand patients’ needs. It then delivered targeted messages to women 40 years and older in the community who had not received a mammogram in the prior 12 months. In tandem, local physicians received messages promoting the organization’s outpatient imaging practice to increase education and referrals. The program led to thousands of new patients receiving this preventative service, and a return on investment of 2,000 percent.

The health system also successfully promoted its urology practice and services with Tea Leave Health’s Physicianology, physician relationship management (PRM) platform. Armed with advanced business intelligence, the organization was able to strategically identify internal medicine and primary care physicians in the area who would be most receptive to a referral message. The campaign established new physician relationships, increased referrals significantly (up to 97 percent) and supported the health system’s goal of delivering more whole-person care.

For more information on how Tea Leaves Health is helping health systems achieve strategic growth and effectively engage their communities, visit tealeaveshealth.com.

About Tea Leaves Health
Tea Leaves Health, a Welltok company, transforms the way healthcare executives manage their business through a platform that provides the total information awareness and business intelligence needed to achieve strategic growth, effective physician engagement strategies and increased revenue. Tea Leaves Health combines a deep understanding of healthcare business development with the technical savvy to deliver strategic success for healthcare organizations of any size. The proprietary Patientology™, Physicianology™ and Decisionology™ software tools easily transform internal and external data into immediately actionable information for multiple leadership levels. While working with clients to develop measurable and successful growth initiatives, Tea Leaves Health strives to provide the best software, strategic consultation and support in the industry. For more information, visit www.TeaLeavesHealth.com

About Welltok
Welltok, the leading consumer health enterprise Software as a Service company, empowers consumers to achieve and sustain their optimal health. Its award-winning CaféWell Health Optimization Platform connects consumers with available and relevant benefits, resources and rewards by designing personalized action plans. Additionally, the company’s technology-enabled services leverage both advanced analytics to derive meaningful consumer insights and multi-channel communications to reach consumers through the right channel with the right message. Welltok drives greater consumer engagement and healthcare value for customers across the healthcare continuum including payers, employers, government programs (Medicare and Medicaid), retail pharmacy and health systems. Follow Welltok on Twitter @Welltok.

 

Media Contact:
Erica Sniad Morgenstern
415.697.3496
pr@welltok.com

 

SOURCE Tea Leaves Health


 

https://www.prnewswire.com/news-releases/tea-leaves-health-significantly-increases-patient-and-referral-volume-for-leading-integrated-health-system-300587937.html


Jan
19

Sleep and Daylight Savings

Days are getting longer, and soon most states will spring forward on March 11. February is the perfect time to begin your daylight savings sleep campaigns. Tea Leaves Health makes this simple through our Neurology – Sleep Disorders Tea Select. All you need to do is identify your geography. Through this Tea Select, you can easily reach men and women ages 26-64 who are most in need of sleep services. Our Tea Selects can always be customized to your needs and budget, and are the best way to reach the most-qualified prospects and patients.

Promoting sleep services via our platform is a simple, cost-effective way to reach current patients and prospects in your market that may be experiencing sleep issues. According to StatisticBrain.com, 40 million people in the U.S. have a chronic sleep disorder, and 30% suffer from insomnia at some point over the course of a year.

Direct mail and email campaigns executed via our platform offer you the ability to connect with these sleep-deprived individuals in your service area to promote your services.

The sleep issues that are searched about most online are sleep apnea and how chronic pain affects sleep. Perhaps including these topics in your digital and print communications will deliver the messages most relevant to your audience and garner stronger response rates.

When executing your campaigns, ensure your calls-to-action are easy to understand and follow. Include CTAs on your pieces that direct recipients to a website, health risk assessment or call center to schedule appointments, or even to the patient portal to book directly. Consider utilizing click-to-call numbers for email creative as well as your online appointment scheduler for screenings.


Further engage your target audience by contacting us for information on how to build awareness about your sleep services.