Enabling Next-Generation Payer Models
Healthcare Transformation Institute (HTI)
The Healthcare Transformation Institute (HTI) is a nonprofit organization dedicated to creating health value by improving health outcomes, access to health services, and the way patient care is delivered. The goal is to better link scientific discovery, healthcare delivery, and the reimbursement for health services, to achieve high-value patient-centric care.
To accomplish this goal, HTI collaborates with a variety of partners that are involved and interested in new approaches to delivering improved healthcare. Together with our partners, we use different strategies, technologies, and services to help interested and eligible health services organizations transform the way they provide patient care. HTI considers ideas that cross organizations, cities, states, the U.S. and address access and delivery of care in rural areas.
HTI functions as a catalyst to help each individual project succeed by bringing resources and/or helping connect project teams with relevant experts from among a wide range of fields. HTI addresses all elements of health services, using measurable outcomes to determine how to deliver better care, reduce costs and develop reimbursement based on the value of health services.
CEO Council on Health and Innovation
The United States spends more on health care per capita than any other nation in the world, and yet its citizens are not the world’s healthiest. The vast majority of U.S. health care spending—an estimated 84 percent—is associated with chronic diseases and conditions such as diabetes and heart disease.
The human costs of an unhealthy population are significant, and so is the economic impact. Some experts estimate that an unhealthy workforce costs U.S. employers $576 billion annually due to lost productivity, health care costs, and wage replacement.2 This threatens the nation’s ability to compete with strength in the global marketplace. Employers have increasingly recognized this fact, as well as the potential they hold to influence the health of the nation.
Employers can have a powerful impact on helping individuals and communities develop and/or maintain healthy habits that can improve health or better manage chronic conditions. The organizations represented on the CEO Council are leading the way toward a new understanding of health and health care, and a new vision of a health care system in which everyone plays an important role. Together they represent nearly one million members of the U.S. workforce and 104 million “covered lives” (e.g., employees, their families, and retirees covered by health insurance). Their impact is broader than this, however, through programs that promote health and wellness in the communities they serve.
These organizations are successful in the marketplace because they recognize and pursue the power of innovation in developing and delivering products and services, managing their organizations, and meeting the needs of their customers. They bring this same innovative approach to improving and supporting the health and wellness of their workforces, developing creative strategies, and employing best practices. Through this Council, these companies are sharing their health strategies and best practices in order to highlight and spread successful initiatives to other organizations.
Goals of the CEO Council
The goals of the CEO Council on Health and Innovation are to:
- Share innovative strategies and best practices that Council members are using to promote health and wellness and improve the quality, cost-effectiveness, and patient experience of care;
- Encourage other employers to implement strategies that will improve health and health care in the United States; and
- Promote learning and improvement by tracking and sharing outcomes and best practices.
CEO Council members are focused on advancing innovative strategies that fall into three pillars:
1. Those that improve the health and wellness of individuals (e.g., employees, their families, and retirees);
2. Those that improve the health of the communities; and
3. Those that improve the health care system.
A Health Care Advisory Board, made up of chief executives of organizations representing clinicians, consumers, and hospitals, is providing expert guidance in this collaborative effort. In addition, former U.S. Senate Majority Leaders and Co-chairs of BPC’s Health Project Tom Daschle (D-SD) and Bill Frist (R-TN) are advising the Council, along with Janet Marchibroda, BPC’s director of Health Innovation, who serves as the Council’s executive director.
America's Health Insurance Plans (AHIP)
Keynote to America's Health Insurance Plans (AHIP) Regarding Precision Medicine in Cancer, the Future of Immunotherapy and the Role of Next Generation Sequencing
Dr. Soon-Shiong was invited to present a speech on Health Care Disruptive Innovation: Moving From Innovation to Impact to the nation's insurance companies. President Clinton was the keynote speaker for this event held in Nashville, TN.
Breakthroughs in Medicine & Technology Summit, Jackson Hole, WY
Convening CEOs of Multinational Pharmaceutical and Insurance Companies to Increase Access to Novel Agents and Payment Models
A select group of world leaders was convened by Dr. Soon-Shiong and co-sponsored by Walgreens CEO Stefano Pessina to gather for three days in a private summit to discuss the challenges facing healthcare and the looming crisis of cancer and cognitive overload.
Cancer MoonShot 2020: Independence Blue Cross
Nation’s First Insurance Coverage of Next-Generation Whole Genome Sequencing and Proteomic Diagnostic Platform Announced by Independence Blue Cross and NantHealth in the War against Cancer
With Today's Announcement Next-Generation Sequencing And Precision Medicine Has Evolved From Research To The Clinical Cancer Setting:
- CLIA-Certification of a Comprehensive Whole Genome tumor normal DNA, RNA and Quantitative Proteomic Sequencing Test (GPS Cancer™)
- Insurance coverage for GPS in patients with Cancer
- Adoption of a payer-provider web-based collaboration platform, called NaviNet Open, enabling doctors and payers to share information in real time with access to over 90% of covered lives in the United States
- CLIA/CAP certification of a Platinum-Rated Human Tissue Repository
Today Independence Blue Cross and NantHealth announced the nation’s first insurance coverage for a comprehensive whole genome and proteome molecular diagnostic platform (GPS Cancer™) to diagnose molecular alterations in an individual’s cancer, and to identify personalized therapeutic regimens. With today’s announcement, the application of precision medicine in the oncology setting has now emerged from research to the clinical cancer setting – a significant milestone in precision medicine and the war against cancer.
GPS Cancer is a CLIA-certified diagnostic test that combines whole genome sequencing of tumor-normal specimens together with RNA sequencing and quantitative protein analysis to identify the protein pathways active in the individual’s cancer. GPS Cancer is the nation’s first CLIA-certified comprehensive DNA/RNA test with quantitative proteomics to receive reimbursement coverage in the clinical setting. Sequencing the whole DNA of three billion base pairs with over 20,000 genes, as well as RNA to identify those mutated genes which express the proteins from a patient’s cancer, provides comprehensive and critical molecular information. Only through this comprehensive test can the physician more accurately identify which of the multitude of molecular alterations that are present in cancer cells translate to abnormal proteins being produced and which are the key targets for many therapeutic interventions. It is anticipated that the commercial launch of the GPS Cancer test will occur by March 2016.
For the full report, click here.