#JoinTheConversation with Experian Health’s Hans Morefield at #HIMSS17
This #JoinTheConversation series is brought to you by our partner Experian Health and the episodes were broadcast live in Experian Health’s booth (#3503) at the The HIMSS17 Annual Conference and Exhibition. The interviews were recorded and published to the media player on this page. Please read more about why more than 60% of U.S. hospitals count on Experian Health.
Hans Morefield, VP of Care Coordination and Population Health Solutions, Experian Health
Joe Lavelle 00:31 All right, I’m Joe Lavelle and I’m so excited to be bringing you “JoinTheConversation” with my co-host Todd Eury right here from the Experian Health booth at HIMSS17. Todd, let’s give a quick shout out to today’s sponsor, Experian Health, what a great partner we have to produce this show today.
Todd Eury 00:47 Absolutely amazing. The energy coming from HIMSS 2017 and Experian Health is powered by the strong healthcare heritage of their legacy companies, plus that deep data and analytics capability of Experian that only they can really bring to the table for the way that they have for years. This unique combination positions them well to help health care providers succeed and I’m excited to be a part of it.
Joe Lavelle 01:11 Absolutely, we are going to get right to it today Todd. We are going to introduce our distinguished guest, Hans Morefield, VP of Population Health and Care Coordination Solutions for Experian Health. Hans, welcome to the show!
Hans Morefield 01:22 Yeah, thank you. I’m excited to be here.
Joe Lavelle 01:24 Awesome, Hans before we get into the big discussion, could you take a few seconds and tell the audience about you and your background?
Hans Morefield 01:30 What’s relevant here actually is that healthcare IT is in my blood. My father was a long time healthcare software executive at Shared Medical Systems and he founded Healthcare Data Exchange coming on 30 years ago, and really the mission of trying to connect the providers and payers and healthcare and make everything work better is something he started and something I’m working on today.
Todd Eury 01:49 Hans, when I think of the evolution of Experian specifically and what you did for data in the financial management institutions and the usage of your identity and identity protection, this only makes sense. Would you please give me a 10000 foot overview of what you and your team does at Experian Health?
Hans Morefield 02:11 Sure, I’m responsible for the Care Management team at Experian and our focus is really to help organizations and sometimes they’re big health plans, sometimes they’re small hospitals, physician groups and others, who have a new incentive and a new reason every day to manage how a patient, how their care is progressing beyond the walls of their organization. Hospitals now care more than ever about what happens after a patient gets discharged. It’s really complicated because the patients are going to places physician groups and skilled nursing facilities who are not on their platform and they’re saying, how do I track and how can I follow them when they’re out there in the community? And it’s a very diverse community, and so we’re building specialized solutions to solve that problem.
Joe Lavelle 02:54 Perfect, let’s start here Hans. Will you define care coordination for us and then describe how Experian Health goes about helping providers do care coordination well?
Hans Morefield 03:04 Sure, care coordination is simply, think of it as just being on the same page. There are multiple different groups, there might be a hospital, skilled nursing facility, the doctor the primary care physician, maybe a specialist is involved and they’re treating one patient, and everyone’s got a role and they’re trying to coordinate their activities to drive the best outcome and to do as efficiently as possible.
Todd Eury 03:25 There’s a keyword that I hear a lot, I don’t know if people throw it around really understanding what it means or if they’re leveraging it for marketing purposes, but let’s talk about something known as value based reimbursement. Why is it important to share post-acute care information in the coming new era of value-based reimbursement?
Hans Morefield 03:46 The old model was really simple, it was just volume based reimbursement. The more you did, the more you got paid. And that’s an expensive model for our industry and for our country, it’s an expensive model for employers, it’s an expensive model for patients. And so really it’s been in the works for 10 years or more that there’s a shift in the industry to say, well, let’s not reward volume let’s reward outcome, and so it used to be hospitals were, hey! Get the patients in, get them out and we get paid based upon how much they’re here, and if the patient went home and then came back to the hospital two days later because they weren’t recovering well, actually the hospital got paid again.
And Medicare said wait a minute and so actually, to their credit, the federal government in this case has been a real leader in changing that behavior by saying, okay we’re going to start penalizing you. If that patient comes back in 2 days, you’re going to get penalized for that, and so that’s rewarding them based on outcome as opposed to on volume, and then the challenges all of sudden the hospital’s sitting there saying, wait a minute now I care what happens after the patient leaves. First of all I’ve got to make sure that they leave on a better footing. And then second of all, I probably need to make sure that the doctor’s office is following up with them, or if they go to a skilled nursing facility, the skilled nursing facility is providing good care because if they mess up, I’m going to get penalized, and so that’s what’s changing the behavior and that’s the idea of moving from volume to value.
Joe Lavelle 05:11 Perfect. Hans, could you give us an example or two of how you’re helping providers succeed in that automated care coordination for episode management?
Hans Morefield 05:18 Sure, so one of the ideas that hospitals have is they have new incentives around what happens after you leave. Well they’re getting discharged from the hospital they’re going home, and the truth is when patients leave the hospital they’re not ready to go run a marathon. They’re not usually completely well. They’re just better that they don’t need to be there at home, but they still need care, and so it’s really important they follow up with their doctor’s office and the challenge is that the hospital now needs assurance that that follow is going to happen, in that they need to know what happens out of that visit. And so what we do is we close that gap in technology between the hospital and the doctor’s office. But therein lies a new wrinkle which is the doctors on one platform, they got their own electronic medical record system, there are a hundred vendors here at HIMSS selling electronic medical record systems for physician offices, and there are 50 more that sell them for hospitals.
So you got all these different EMR’s and none of them really talk to each other in a meaningful way. How do you bridge that gap between the two things, and there are really two strategies to doing that, one is you just try to get everybody in the community to use another system, and then you run into the issue that no one wants another system. Everyone’s like I know, I got a system and so we do it really cleverly through email, because emails actually the system that everyone already uses, and so we’ve figured out a way to drive workflow in a closed-loop process and communicate well through the simplest of technologies email and it’s been a big success.
Todd Eury 06:47 The common denominator right?
Hans Morefield 06:49 That’s right.
Todd Eury 06:50 What can you tell us about your first to market care coordination tool?
Hans Morefield 06:56 That’s basically this platform. So what we did was we said, let’s build a really configurable workflow system. Just put in lots capabilities, lots of intelligence, lots of flexibility, so it can work for a hospital to a doctor’s office. It can work for coordinating with a skilled nursing facility between a hospice and a Home Health. It can be used by health plans all sorts of organizations, so we have to build something that was really sophisticated and powerful, but then the most important feature was it had to be incredibly simple and obvious by hiding it in email. So that’s what we’ve done with care coordination manager. We built like this really powerful tool, but everyone just looks at it and says well that’s email and I know how to use it, and so that’s why it’s worked really well.
Joe Lavelle 07:37 Hans we always bring our crystal ball to HIMSS and we ask people to look into it. Tell us as you look into the crystal ball here in front of us, how do you see care coordination evolving the next three to five years?
Hans Morefield 07:48 If I say it will be solved in three to five years, then I’m lying because nothing in healthcare moves that quickly and some of these are projects that the industry has been working on for 30 years and I know that really well. I think the answer is in 3 years we may get to, we may only get a quarter of the way there. When you’re talking about a situation where you have 5,000 hospitals, you have 30,000 skilled nursing facilities and home health agencies, you’ve got tens of thousands of physicians group a lot of them are still one and two and three doctor practices, The reality is there’s just a massive, massive market of complexity and so there a lot of great ideas, we’ve got a particularly good one for handling those odd balls and the providers that aren’t big ones that are on the big platform, so there’s a lot to tackle out there. We’re going to be busy at it for years.
Todd Eury 08:33 Hans, what can you tell us about Experian Health’s strategies and its success in matching members?
Hans Morefield 08:38 Yeah, one of the biggest elements here is that everyone’s involved with a patient. Some of them look at it as, whether you’re a health plan or an accountable care organization you say, well that’s my beneficiary, that’s the person I’m responsible for. And then you got the hospitals and the doctors and the others and they’re all saying I’m treating a patient. They don’t all understand when that one person they’re talking about is the same person. So, when a patient shows up at the hospital the health plan would love to know that they’re there, the accountable care organization would like to know that one of their beneficiary has been admitted, and so there’s a process there where you know you need to do matching, and so we’ve got a solution called Member Match. We’ll basically be able to notify health plan or accountable care organization when one of their beneficiaries gets admitted or discharges goes to any emergency room connected to our network and it’s a massive network.
Todd Eury 09:24 You’re taking the term of being patient-centric and you’re taking the center of what Experian has done all along. And now you’re delivering it, so it’s become very sincere.
Hans Morefield 09:36 In the credit reporting side, the traditional Experian would take data from thousands of businesses and banks and others and say I can assemble a credit picture of an individual over a lifetime, and we’re building that same capability on the health side and it’s pretty exciting.
Joe Lavelle 09:55 Perfect. Hans, it looks like we’re running up against the clock. Before we let you go where can people go to learn more about the population health and care coordination solutions from Experian Health?
Hans Morefield 10:05 Well, where they can learn about everything at Experian Health at our website, www.experianhealth.com.
Joe Lavelle 10:11 Perfect. Hans, it was so great to have you. Thanks for sharing your wisdom and your expertise on care coordination and population health.
Hans Morefield 10:17 Sure, I really enjoyed it. Thank you.
Joe Lavelle 10:19 All right, I appreciate it. That wraps this live broadcast from HIMSS, thanks to our sponsor Experian Health. On behalf of our guest, Hans Morefield and my co-host Todd Eury, I am Joe Lavelle and we hope you stay tuned for more of Intrepid Healthcare’s great “Join The Conversation” coverage live from Orlando.
About Experian Health
More than 60% of U.S. hospitals count on Experian Health. These providers—along with thousands of medical practices, labs, pharmacies and other risk-bearing entities—are making smarter business decisions, boosting their bottom lines and strengthening patient relationships. Our clients have discovered the value of our revenue cycle management, identity management, patient engagement and care management solutions to power opportunities in the new era of value-based reimbursement.
Experian Health is powered by the strong healthcare heritage of our legacy companies, plus the deep data and analytics capabilities of Experian. This unique combination positions us well to help you succeed.
Revenue cycle management solutions automate orders, patient access, contract management, claims management and collections to improve efficiency and increase reimbursement.
Identity management solutions match, manage, and protect patient identities to enable accurate patient information and to safeguard medical information.
Patient engagement solutions connect patients with personalized portals to create price estimates, apply for charity care, set-up payment plans, combine payments to hospitals and physicians and schedule appointments.
Care management solutions organize and enable sharing of post-acute patient care information to help providers succeed in the new era of value-based reimbursement.
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