Here are five key metrics that executives should pay attention to as they navigate challenges.
Healthcare executives see an array of statistics and metrics on an almost daily basis as they try to stay ahead of the many curves that come from managing a business in today’s healthcare environment.
Here are five important metrics that should have the attention of executives as they navigate challenges.
“A millennial views their experiences around convenience,” says Ash Shehata, principal at KPMG and partner of the firm’s Global Healthcare Center of Excellence. “Health plans have to be able to offer their capabilities at a millennial’s moment of need. Those capabilities have to be offered on multiple platforms, both digital and non-digital, and in person or off premises.”
“With an aging population, increased prevalence of poly-chronic illness, and ever-increasing budgetary pressures amongst plan sponsors relative to medical and pharmacy cost management, emergency department utilization is a key cost driver and key area of focus,” says Managed Healthcare Executive Editorial Advisor David Calabrese, RPh, MHP, senior vice president and chief pharmacy officer for OptumRx.
“The individual MSSP measures don’t really have any disproportionate weighting (23 measures across 4 domains),” says S. Lawrence Kocot, leader of KPMG’s Center for Healthcare Regulatory Insight. “Each measure is worth two points, and each domain is weighted at 25%. The at-risk population and care coordination/patient safety measures are worth more since there are fewer measures in the domain. The number of total measures is down from 33 in the first few years, at least in part because some related measures have been rolled up into a single one (e.g., diabetes, which previously had multiple separate measures and is now just one).”
“In the past, health plans moved at their own pace of innovation,” Shehata says. “In the future, expectations that consumers have for financial services companies, retailers (both brick and mortar and online), and others will raise expectations for their health plan experience. Technology will become much more available and consumable. Consumers are demanding this type of interaction, and health plans can no longer use excuses to avoid upgrading their infrastructure to meet this expectation. It is an unavoidable future.”
“The most highly rated D measures are the Drug Plan Quality Improvement Measure and the three drug adherence measures: Medication Adherence for Diabetes Medications Intermediate Outcome Measure, Medication Adherence for Hypertension (RAS antagonists) Intermediate Outcome Measure, and Medication Adherence for Cholesterol (Statins),” Kocot says.