If I had a dollar every time an Enterprise Architect said, “I have a Road Map,” and handed me the future state IT architecture (which is 5 years out) and proceeded to verbalize current to future IT while I madly wrote every word down in preparation for a Business Transformation Session to prioritize/re-prioritize initiatives, well […]
Christel Kellogg
Blogs from this Author
Member-centric Care: Open source to the rescue?
A must read from my colleague, Martin Sizemore, entitled, “Is it time for open source in healthcare?” Wow! This Business/Process with system enablement person, me, can understand this architecture stack. Yes, now more than ever we need open source. Prototyping Open Source for testing ICD-9 to ICD-10 with on the fly remediation before going to […]
ICD-10 Revenue Neutrality Will Drive Collaborative Testing
I was reading my collegue Mike Berard’s blog, on ICD-10 Revenue Neutrality: A Strategic Approach. We have discussed the importance of testing before production between Payer and Provider (e.g., Physicians and facilities). In his 2nd to last paragraph Mike proposes the following: “The reality is that Revenue Neutrality verification is still subject to the availability […]
ACO: Maybe I am wrong and Payers will not be Partners
About a year ago I blogged, “Will we be reading in 2011 ACOs partner with large carriers?” I am hearing that carriers are staying away from ACOs and are not planning on partnering. What have you heard? Was my assumption incorrect in 2011?
ACO – A Brave New Enterprise: Are you ready?
Racing towards an ACO and Population Management this year is a huge challenge. A new enterprise platform is a must for an ACO to coordinate the changing of Provider and Payer processes and behavior not to mention the Shared Savings contracts which require new measurements and reporting: a shared dashboard. Check out Martin Sizemore’s take […]
Member-Centric Care: Are we enabling the Next Generation of SMEs?
A struggle for the Payer/Provider Industry is how to prepare the next generation of Subject Matter Experts (SMEs). Now more than ever you need the experienced Medical Directors, Clinicians, and Non-Clinicians on your multiple #1 initiatives. Are you preparing your next generation of SMEs? Yes, you do need the 20-25 years EE on the project […]
Member-Centric Care: Have we over turned every rock?
In my previous posts about the Member-Centric Care team, I posed several questions and gave my opinions to support them. Here is a review of what was discussed, as well as new thoughts: Have we over turned every rock (e.g., process, operation, and IT enablement) to allow for member-centric care? It Depends – Sorry, I […]
Member-Centric Care: Are we working on the correct priorities?
In my previous blogs, I asked if we were missing a key player in member-centric care and then provided my opinion. Here is a recap of questions and answers I discussed, as well as some new points: Are we, business and information technology professionals, clinicians, and non-clinicians, working on the correct priorities for member-centric care […]
Member-centric Care: Missing a Core Team Member
In my last blog post I asked if we have missed a core team member in member-centric care. My answer: In Sales there are the Health, Life and Supplemental Insurance Agents for employers and members that are responsible for mentoring members on plans, eligibility and benefits as well as understanding claims. These individuals make a […]
Member-centric Care: Have we missed a core team member?
Recently rolled off a large payer, I am sitting back and reflecting on what is facing the healthcare industry today and what has happened over the past 15+ years (Looking at the forest rather than the trees). 1) Are we, all business and information technology professionals, clinicians, and non-clinicians, working on the correct priorities for […]
Accountable Care Organizations: Will we be reading in 2011 “Community ACOs Partner with Large Carrier”?
I was reading “2011 Predictions: MU Goes Tactical, ACO Strategic” where John Moore, Chilmark Research, lists 2011 key IT healthcare trends. I have a payer background so my view of ACOs is slanted to the systems and processes that have been put in place over the years at Payers (DM, CM, UM, Wellness, Pharmacy Benefit […]
ACO: “If you build it, they will come”. Really? Not without a Payor Marketing Plan.
There is an ACO belief out there that “if you build it, they will come.” This belief is all based on honorable intentions for the patient and our communities. I just want to know what marketing plan and mobile application was used to contact all the baseball fans to go to Iowa in the movie […]