Blog Posts Health IT Process Management Process Modeling

The Path to an Easy, Powerful, and Unified Health Plan System

Blog: Appian Insight

In case you missed it, Monday, there was a fantastic session at the National Conference on Medicare & Medicaid in Washington, DC: Celebrating 50 Years of Public Programs.

On stage to discuss the past, present and future of the Medicare program, was Marilyn Tavenner, the former CMS administrator and current CEO of American’s Health Insurance Plans. As part of the session, Ms. Tavenner interviewed three former CMS administrators: Mark McClellan, MD, Ph.D., Thomas Scully, and Gail Wilensky, Ph.D.

Did you miss today’s #McareConf? Here’s a glimpse of what happened pic.twitter.com/HBWKNUEZhD

— AHIP Education (@AHIPEducation) October 19, 2015

In short, our current Medicare system is the product of smart people working under tight deadlines in what’s largely a cooperative environment. Among the panel’s descriptions and predictions of the future of public programs:

There will be tremendous consolidation among medical practices, and hospital and health systems.
There is a tremendous need for better, more proactive and real-time means to detect and dissuade fraud, waste, and abuse.
Tremendous potential exists for quality measurement and information technology to improve outcomes, experience, and cost.

It should come come as a surprise that common themes were brought up consistently at the American’s Health Insurance Plans conference in Nashville last June: How can we, collectively, in the private and government sectors, incent better care and intelligent choice by healthcare providers and consumers? Our current system is too difficult for patients and providers to navigate, provides insufficient incentives to accomplish necessary tasks and goals, and is too fragmented to allow easier and more powerful solutions. The only way forward is through innovation. “Innovate” was a word heard quite a bit at this year’s Medicare and Medicaid conference. So I looked up its synonyms:

Innovate: change, alteration, revolution, upheaval, transformation, metamorphosis, breakthrough.

Strong words! Innovation is driven primarily by people and ideas. But technology is also key realize those ideas. The ability to rapidly create and deploy intelligent, business process-based applications is a strong enabler of innovation. It gives business the tools needed to succeed or to fail fast, to learn from their experiences and to incorporate those lessons into their next innovative solution. The passion and creativity of commercial and public health insurance professionals, collaborating closely with leading technology platforms help people be as creative and driven as the former CMS administrators I listened to on stage. It’s about creating powerful applications that just work on all modern hardware and devices and provide unified views of patient data and workflows from across disparate enterprise systems. No one can build these modern, easy, powerful, and unified applications from scratch quickly enough. This is where the Business Process Management (BPM) application platform comes it. Draw the workflow. Drag and drop to create the user interface. Click to install adapters accessing enterprise data. Then click once more to generate cross-mobile-device native apps.

#McareConf #McaidConf Easier, better, unified care needs easy, powerful and unified technology to deliver outcomes! pic.twitter.com/ntq8sFGmMR — Christina Fisher (@cfisherappian) October 20, 2015