Tag Archives: university of pennsylvania

Time to Formalize Insurance Career Path

An industry cannot thrive without new ideas and talented people to lead it into the future. That’s why I believe there must be an educational program for individuals entering the insurance business.

It has become increasingly evident over the past several years that we’re confronting the twin problems of an aging workforce and a dearth of new professionals. It’s crucial for industry veterans and leaders to elevate and accelerate this conversation.

We must advocate for and help build academic programs, apprenticeships and on-the-job training opportunities that lay the foundation for success — as well as continue to teach insurance professionals throughout their careers. It’s up to us to shape a more vibrant future.

It’s common for aspiring professionals to graduate from business school and then be left to fend for themselves when it comes to getting licensed and starting work. This limited training rarely teaches students the range of theories, skills and legal requirements necessary to understand such a technical industry.

Institutions like the University of Pennsylvania and the University of Georgia offer an emphasis in risk management, but it only accounts for a handful of classes in a general MBA program. I’d like to see more colleges and universities create programs focused on risk management alone.

Insurance experts can help academics design curricula explaining the richness and variety of the industry. The career can encompass many specializations, from sales agent to claims manager and underwriter to evaluation specialist. Students should be exposed to these exciting career possibilities.

See also: 4 Keys to Charting Your Career  

Academic institutions are beginning to shift in the right direction. In 2006, 58 risk management degree programs prepared 1,562 graduates to become insurance specialists. That number climbed to 112 programs with 1,870 graduates by 2010.

Despite that rise, the programs still account for only a fraction of the more than 4,600 degree-granting post-secondary institutions in the U.S. that enroll more than 20 million students. We can do better. Our focus should be on building more academic programs to attract more students and better preparing them to join our ranks.

To best equip students, it’s imperative that we augment classroom learning with apprenticeships and on-the-job training. Even after 44 years in the industry, I still learn something every day. Every time I reach a career milestone, I’m reminded of how wrong I was to think that at year five or year 10 — or even year 20 — I knew all there was to know about the industry.

By offering apprenticeships, insurance companies can provide students and new graduates with an invaluable learning environment. This learning shouldn’t stop after the first couple of years on the job, either; we should design early- and mid-career training courses to keep our colleagues engaged and to reward the dedication of not only the students, but also the instructors.

The average age of an insurance agent in the U.S. is 59, and a quarter of the industry’s workforce is expected to retire by the end of this year. It’s imperative that these industry mainstays pass their valuable institutional knowledge along to students and colleagues with less experience.

Only 4 percent of millennials view the insurance industry as a potential career choice. Young professionals harbor the opinion that the insurance industry is inherently boring. If such a small fraction might consider insurance for a career, how is it possible to combat the stereotype that the industry is boring without established educational programs?

Therein lies our challenge: It’s up to those of us in high-level positions to forge a more formal career path and teach the next generation how fulfilling the insurance industry can be.

There are some instances in which the industry excels at recruiting and retaining young professionals. Agents under age 40, or with less than five years of experience, can join the Young Agents program — a section of the Independent Insurance Agents and Brokers of America. The program allows members to connect with various professionals, attend conferences and access helpful resources. Young Agents furthers early-career employees’ engagement and illustrates the many avenues for advancement and success in the industry.

But we still need an unwavering commitment to comprehensive education. Insurance companies have to prioritize and invest in academic programs that maximize students’ knowledge — and employee retention.

See also: 3 Reasons Millennials Should Join Industry  

Our industry is about ensuring the health, happiness and dreams of individuals. When we join the insurance industry, we inherit the responsibility of protecting what people value most. No amount of time in the industry can allow us to take that responsibility lightly.

We must look beyond the sense of duty we might feel toward our current clients and begin preparing the agents who will come after us. Only then will they be able to reliably and proficiently serve our future clients.

It’s up to our industry to train, educate and provide experience and teachable moments to foster the growth of new graduates and transform them into well-trained agents. We must help our colleagues attain their hopes and dreams, too.

5 Breakthrough Healthcare Startups

The 2016 HITLAB Innovators Summit and World Cup was held once again at Columbia University in New York. There were 74 technology companies that entered the competition, and five finalists were selected. All of these startups that entered the competition and others that help sponsor this annual event have the potential to help improve the way healthcare is delivered now and in the future through innovative technologies.

Near Infrared Imaging (NII), based in Wrentham, MA, has developed a technology for the enhanced visualization of veins. This technology, called the Vein-Eye, is a hands-free, non-invasive hospital cart that provides real-time imaging of the veins below the surface of the skin. Michael Feeney, president of Near Infrared Imaging, said, “Vein punctures can be very painful, especially for difficult patients who may be obese, very young, very old and/or have dark skin.” Multiple attempts to puncture a vein result in a very negative experience for both the patient and the provider.

The first specific successful application of the Vein-Eye is varicose vein treatment. The Vein-Eye is also targeting patients receiving dialysis, patients with severe burns, patients with Thalassemia Major Disorder and patients undergoing FLAP surgery, which is a technique involving lifting a tissue from a donor site to a recipient site. Roughly 25% of all patients, regardless of healthcare setting or illness, have delayed care due to the inability of a healthcare provider to establish an IV access to the patient’s vein. NII is also working to develop a patented technology that will detect real-time bleeding in the brain at the scene of the injury.

MedLogiq, based in Hazlet, NJ is bringing technology originally developed and used by the automotive and aviation industries to testing and monitoring product quality and performance in the medical device marketplace. This proven technology comes at a time of increased concerns about product defects in a wide range of medical-devices, resulting in serious injuries to patients and massive product liability lawsuits. The FDA has expressed serious concerns with these adverse events and has significantly increased actions against medical device manufacturers.

See also: 5 Apps That May Transform Healthcare  

Bill Acevedo, the CEO of MedLogiq, said: “Our solution provides value from proof of concept through end of life for medical device manufacturers and any other stakeholder.” Acevedo went on to say; “Medical device manufacturers don’t know what they don’t know.” There are many key questions that need to be asked and independently verified about medical devices. Is there a design defect? Was it built correctly? Is there a potential for patient harm or product liability? What data points are needed for continued monitoring of quality outcomes?

Jim Zerka, CFO, said: “Our main objective is to improve patient care and outcomes by reducing adverse events.” Acevedo closed his presentation by stating that this quality control technology was used by Ford to ensure manufacturing quality of every car coming off their assembly lines worldwide.

MedLogiq, along with their technology partner MAHLE Test Systems, has been granted access to the intellectual property for the generic infusion pump (GIP) from the PRECISE Center at the University of Pennsylvania to integrate their solution as the “maintenance processor” to accurately measure and report device performance. The GIP was built by the PRECISE Center to the FDA specifications to enhance safety monitoring, performance testing and event data recording capabilities for infusion pumps designed to administer fluids and medications to patients in a precise manner.

Green Sun Medical, based in Fort Collins, CO is revolutionizing the treatment of adolescent idiopathic scoliosis (AIS). AIS is a condition resulting from a curvature and rotational deformity of the spine. This condition develops in 3% of children under the age of 16. This results in the incorrect rotation of the spine and creates a prominent rib hump in these children. Most patients are diagnosed because of this rib hump, and when it progresses past 30 degrees they are prescribed a traditional brace. Current braces involve a 40-year-old technology, which is a rigid brace that the child must wear as much as 23 hours a day. Needless to say, these traditional braces are terribly uncomfortable and can create pressure sores, also known as bedsores or pressure ulcers, that can result in severe infections and must be worn until the child becomes skeletally mature. If the condition progresses past 50 degrees, surgical intervention is required, with the average cost exceeding $150,000. In addition, surgical intervention results in a 50% complication rate over the patients’ lifetimes.

This new solution is transforming spinal bracing technology and treatment options for spinal deformities through the use of a comfortable dynamic brace with built-in sensors linked to an iPad that provides physicians and family members comprehensive brace pressure information and compliance data in real time through a “report card.” This report card allows for corrections and adjustments to the brace. This technology will prevent children from the pain and suffering of antiquated braces and prevent needless surgeries.

In addition, Green Sun Medical has created a new dynamic brace to help both adults and children with Kyphosis. Kyphosis is a forward rounding of the back and can result in a much exaggerated and very painful rounding. This can occur to anyone at any age but is most common in elderly women.

Green Sun Medical won the award at the Wilson Sonsini Goodrich & Rosati Medical Device Conference in June 2016 as the #1 new medical device in the U.S.

EarID, based in Cambridge, MA, screens and diagnoses ear infections with higher sensitivity and specificity than existing clinical methods by using new 3D imaging and data analytics on a cloud-based platform. EarID assists in ear infections monitoring and management by minimizing unnecessary antibiotic prescriptions and time lost from work by parents and from school by children. Ear infections are the #3 reason for absence from school by children and most likely cause a parent to also miss work.

See also: AI: The Next Stage in Healthcare  

Anshuman Das, a post-doctoral associate at the MIT Media Lab and MIT Tata Center for Technology+ Design, noted that the primary screening tools for ear infections has not changed since the 1800s, and his research has found that accurate diagnosis of ear infections is not currently met in pediatric care. The current diagnosis of ear infections relies on visual inspection of the eardrum, which is performed by a device called the otoscope, which gives very little quantitative information about the actual health of the ear. EarID overcomes these challenges by integrating the conventional otoscope with a structured illumination system that greatly enhances optical and anatomical information about a patient’s ear drum. In addition, the technology with enhanced diagnostic capabilities helps address the overprescribing of antibiotics, which is a well-known public health crisis. (https://tatacenter.mit.edu/portfolio/earid-smart-ear-imaging/)

UE LIfeSciences, based in Philadelphia, PA, is on a mission to make effective breast cancer screening accessible in the developing world and was the winner of the 2016 World Cup. Matthew Campisi, CTO and co-founder, noted that 50% of the breast cancer diagnosed today is in the developing world, with 70% in the Pacific Rim/Southeast Asia, where two-thirds of cases are first diagnosed in stage 3. The company’s technology is currently being used in India, where the death rate from breast cancer is twice that of the U.S. This technology provides a battery-powered handheld wireless device that can store and send data and is accessible anywhere in the world. It is painless and radiation-free and allows for early detection of breast cancer.

UE Life Sciences’ first product, NoTouch BreastScan, is an FDA-cleared device and in a recent clinical trial detected early stage breast cancer with 87% accuracy. The second product, iBreastExam, is a handheld breast scanner that uses a smart phone as its monitor. The development of this technology was funded by the PA Department of Health to address the fact that 90% of the developing world and millions of women do not have access to breast cancer early detection.

Exhibitors at the HITLAB Summit included several other healthcare technology companies such as AdhereTech, based in New York, which has invented a smart wireless pill bottle. AdhereTech was the winner of the first HITLAB World Cup in 2013. Its “smart” pill bottles are being used by patients in pharmaceutical and research engagements and can collect and send data in real time. This system automatically analyzes information, and, if the patient misses a required dose, he receives customized alerts and targeted interventions by cell phone, text messages, etc. This amazing technology requires zero patient setup and recharges just like a cell phone and lasts as long as 5 years. Josh Stein, the CEO, told me the entire purpose is “to see that patients are taking the correct medication at the right time. This is particularly critical for patients diagnosed with cancer.” (www.adheretech.com)

Citus Health, also based in New York, has created a solution named “Call Bell” to help revolutionize how home infusion companies connect with patients. Melissa Kozak, CEO, told me she invented this technology after spending seven years as an on-call nurse for a home infusion company “to help keep my patients out of the hospital.” Kozak experienced firsthand how home infusion patients often needlessly face tremendous anxiety along with many potential adverse events such as delays in receiving antibiotics, chemotherapy, nutrition etc. when patients’ home infusion care process breaks down. The current system typically involves after-hours call centers that are inefficient and typically provide an answering service, not a certified nursing expert. Call Bell allows patients to get answers quickly in real time to address IV support questions and troubleshooting along with answers to questions like, when will my nurse arrive, or when is my next delivery? In addition, this technology provides home infusion companies with accurate patient home infusion supply counts with vastly improved patient support and communications. Call Bell was designed to address the Holy Grail of healthcare, better patient care and better outcomes at a reduced cost.

See also: Consumer-Friendly Healthcare Model  

It was a real pleasure once again to meet so many amazing people developing state-of-the art solutions for an array of global public health issues through new technology. I wish them all continued success and look forward to the 2017 HITLAB Innovators Summit, Nov. 28 -30, 2017 held once again at Columbia University.

Why Healthcare Costs Bleed Firms Dry

“It is impossible to prove something to someone whose salary depends on believing the opposite.” – Upton Sinclair

Today’s overpriced healthcare system is hurting American businesses and job creation, eating into profitability and, quite frankly, bleeding companies dry. What’s worse, the lack of cost control and price transparency have created a culture of helplessness and even resignation.

But employers have had enough. Many are rising up and demanding change. They want lower costs and better care for their people and will no longer tolerate the status quo.

In 2007, I made it my mission to put an end to overpriced healthcare when my own companies’ healthcare costs were cutting dangerously into the bottom lines. At the time, I operated numerous healthcare clinics throughout the Phoenix metro area. We found our best hourly employees were leaving us for jobs at larger corporations with better health insurance, and we couldn’t attract replacements with the same level of training. Productivity and efficiency plummeted. It was an absolute mess, and I felt like a failed CEO.

But we discovered a secret that no one else seemed to know – or at least nobody seemed to be saying aloud. It’s a secret we uncovered when we started doing something I had never heard of anyone doing: writing our own checks for our employees’ healthcare.

See Also: When a Penalty Is Not a Penalty

It seemed strange that the cost of giving birth at one hospital was $6,000, while the cost at a neighboring hospital was $17,000 – even though the same doctor had attended both births! Strange that an ankle X-ray could cost $1,200 in a hospital emergency room but only $35 at my own clinics. Stranger still that a simple antibiotic could cost $900 at one pharmacy when Walmart sold the exact same drug for only $12.

Those observations helped lead to the secret to not overpaying for healthcare.

Controlling PLACE OF SERVICE is all that really matters

In the vast majority of cases, my employees could receive the right level of care in a setting that provided the same service (with the same or even better quality) at a much lower cost than in another setting.

Of course, sometimes a hospital emergency room visit is absolutely necessary. On occasion, an urgent care is the right option. But qwe saw that many medical expenses were needlessly incurred in hospitals and other expensive settings. MRIs, X-rays, blood tests, specialists consultations and other common procedures were costing my companies five to 20 times more than the exact same services performed across the street in an imaging center, lab or doctor’s office not owned by the hospital.

Why would someone choose to get a $3,600 MRI or $1,200 X-ray at a hospital instead of going to an imaging center across the street for an equally good, $400 MRI or $35 X-ray? Why would anyone get a procedure at one hospital instead of paying 40% less for an identical procedure at another hospital around the corner? It’s not that people don’t care. THEY DO! The answer is that they simply don’t know – and the system is designed so that it is very hard for people to uncover this truth.

It seems crazy, but this sort of thing happens systematically all the time. When employer health plans work well – when prices are transparent and employees are protected and guided away from overpriced services – then common sense prevails and costs stay in check. But if people are part of a health plan that benefits from keeping costs hidden – and most do – business owners and their people simply don’t know they’re being duped.

Why is this is happening? 

  1. Hospitals with the greatest market share negotiate much higher reimbursement rates from insurance companies. A December 2015 study by researchers from Yale, University of Pennsylvania and Carnegie Mellon University analyzed billions of hospital clams paid by commercial insurance companies to hospitals. The study concluded that costs at hospital systems with significant market share were as much as 12 times higher than other, smaller hospitals – with no difference in quality. It was an important and revealing study, yet it failed to evaluate the even bigger differences in price for routine procedures performed at a hospital vs. outside a hospital – procedures that never needed to be done in a hospital in the first place. These price differentials and subsequent overpayments are even more shocking and have the biggest impact on overall healthcare cost.
  2. Hospitals are “buying” doctors so they can fill beds and price excessively. Even though hospitals lose approximately $165,000 each year for every primary care doctor and about $300,000 for each specialist they hire, this strategy has proven effective; it increases market share and allows hospital systems to negotiate higher prices with insurers. What’s more, these doctors are obligated to refer their patients for services or specialty care in an exorbitantly overpriced hospital setting. Of course, emergency procedures are occasionally necessary, and of course hospital infrastructure costs are always higher and will need to be taken into account when assessing fair pricing. But when millions of dollars are used to market elective services that are arbitrarily priced much higher than what is fair – well, this just shouldn’t feel right to the unknowing business owner and employee. After all, they trust the healthcare system to guide and care for them.
  3. Urgent care centers are now owned by hospitals. It’s no surprise, then, that urgent cares are owned by hospitals, providing a perfect entry point for funneling services and profitable patients to hospitals and the doctors who are employed by those hospitals. Following this same line of thinking, urgent cares also help hospital systems gain market share, negotiate higher rates and “mine” the sickest people from among those patients.
  4. There are huge price differentials in prescription drugs. This problem is rampant in the healthcare industry, even extending to runaway prices in common prescriptions. The costs of medications vary dramatically depending on the pharmacy, the insurer and the way the doctor writes the prescription. The cost of a simple generic antibiotic can range from $12 at a grocery store to more than $50 at a widely known national pharmacy – and to more than $900 for the brand name that legally gets substituted when the pharmacy chooses. You might think the answer is obvious – just stop overpaying – but many people simply aren’t aware of the pricing tricks.
  5. High-deductible health plans partner with hospital systems. Often, such plans require that services be performed exclusively at a particular hospital’s health centers or affiliated urgent cares, imaging centers, doctor’s offices, etc. In other words, the hospital system that has negotiated higher rates with insurers now requires health plan participants to use their overpriced services. They say they have negotiated lower prices, but we see that costs are much lower when a patient pays cash outside the hospital.

In the case of high-deductible plans, it’s employees who get stuck with much of the bill. The premiums are cheaper upfront, but employees and their families are charged for services until their deductibles are met, often paying inflated prices for procedures performed in a hospital or affiliated setting. When they can’t afford to pay the deductible, employees often direct their frustration at their employers for providing this sort of coverage. And, sadly, many low-wage people will decide to forgo needed care.

See Also: Why Healthcare Costs Soar (Part 6)

What if brokers could help their small business clients by providing the negotiated fee schedule with the hospital system employees will be required to use? Or at least educate them about the dangers of using hospital facilities for services that could be performed outside a hospital? This is especially important for people with high deductibles.

Though it’s not common to request the price list – and insurance companies won’t grant the request – it’s certainly common sense. Shouldn’t employees understand the costs before choosing a doctor or facility? Simply providing the fee schedule would at least give them and their doctors a fighting chance to make care decisions based on both quality and value.

Increased transparency in an industry of hidden costs and unexpected medical bills would be a powerful step toward saying “NO” to the overcharging that the biggest healthcare facilities get away with every day.

The Importance of Data

Educating and guiding employees to the best places for service will have a huge impact on moving the cost needle. And, using data to identify the sickest employees and understand where they are getting their healthcare services is a great multiplier that brokers can use to help their business clients achieve more cost savings.

If an insurance company will not agree, in writing, that all of the company’s data belongs to the business owner – regardless of whether they’re certain to renew – the business owner should walk away.

Most traditional insurance companies will tell business owners they can’t give them this data because of privacy laws or HIPAA. The real reason is that they don’t want their clients to share the data with competing insurers and potentially lower their healthcare costs. In reality, business owners can own their data. Nothing in the law says otherwise. (Employers should never directly look at employees’ personal health information. This is just common sense.)

We encourage business owners to push harder and challenge the status quo way of thinking. We want them to demand cost transparency so they can control their own costs and still take great care of their people. Owning their employees’ data will enable the employer and their broker to negotiate fair pricing and educate their people about place of service more effectively. Brokers who rise to this challenge will find great opportunities to grow their business and create undying loyalty among their clients.

Status quo healthcare costs are bloated with unnecessary administration, waste and overpricing, but businesses and brokers who understand how to choose the right place of service can save money and easily fund healthcare. The worst thing we can do is pay more.

Are Annual Physicals Really Worthless?

Dr. Ezekiel Emanuel wrote a contrarian opinion piece in the Jan. 8, 2015, issue of the New York Times titled, “Skip Your Annual Physical.” Dr. Emanuel is an oncologist at the University of Pennsylvania and was an adviser to the Obama administration regarding the design of health reform. He is also the brother of Rahm Emanuel, a former presidential chief of staff.

As you can guess from the title of the opinion article, Dr. Emanuel believes that annual physicals are not worth having because they do not reduce mortality. He cites a Cochrane Review study to back up his statement. Click here to read a summary of the study by the American Association of Family Practice.

Dr. Emanuel’s comments bring the following question to mind: How is one to have the evidence-based screenings recommended by the U.S. Preventive Services Task Force (USPSTF) without an annual physical?

Here is a list of some of the USPSTF screenings and interventions that studies have shown to be of value by reducing morbidity or mortality that could be accomplished at an annual physical:

  1. Screening for Type II diabetes
  2. Screening for hypertension
  3. Screening for lipid disorders (e.g. high cholesterol)
  4. Screening and counseling for alcohol abuse
  5. Screening for cervical cancer every 3-5 years
  6. Screening for obesity
  7. Potential use of aspirin for the prevention of heart attack
  8. Counseling on folate vitamin supplements for all women capable of pregnancy to prevent neural tube defects
  9. Counseling overweight and obese patients to improve their diet and exercise habits

Source: American Association of Family Practice

Many of these conditions are not rare.  For example:

  • 9.3% of the U.S. population has diabetes-of whom, 9 million are undiagnosed (Click here for ADA source). Assuming a U.S. population of 300 million, 9 million is 3% of the population, so three in 100 screenings would find undiagnosed diabetes. In a company with 1,000 employees, screening for diabetes would result in identifying 30 new cases of diabetes.
  • 29% of the adult U.S. population has hypertension-17% are undiagnosed (Click here for CDC source). 17% of 29% is about (again) 3% of the adult U.S. population, so three in 100 screenings would find undiagnosed hypertension. In a company with 1,000 employees, screening for hypertension would result in identifying 30 new cases of hypertension.

An annual physical is a great way to address these nine proven screening tests and interventions that will lengthen life and reduce suffering. This is only a representative sample from the USPSTF.  There are actually more than nine. You would not “technically” need an annual physical, but you would have to have some other mechanism for having these screenings and interventions performed.  A similar point is made by the American Academy of Family Physicians in its review of the Cochrane study. However, the use of the doctor’s office as the setting for the screening means that if an abnormality is found (i.e. diabetes, hypertension, etc.), then the doctor can prescribe an intervention.

To skip an annual physical and to not have the screening performed some other way-and followed up on-is hazardous to your health