By Tom Still
MADISON, Wis. – The logjam in Washington, D.C., over federal health-care policy might lead some people to fear the “Obamacare” stalemate threatens to stifle innovation from top to bottom in health care.
Not so. At least, not in Wisconsin.
The latest effort to repeal the Affordable Care Act, or Obamacare, is emblematic of deep political divisions over how best to provide health-care coverage to millions of Americans. However, that debate is not standing in the way of hospitals, medical professionals, insurers, entrepreneurs and others from working on better, more efficient ways to care for patients.
That was evident last week in some massive settings, such as Epic System’s annual user group meeting in Verona. Chief executive officer Judy Faulkner challenged her company’s electronic health record customers to think about patients as not just a collection of “big data” but as people with health concerns and conditions that may be improved through emerging technologies.
Health-care innovators in other settings are also not content to wait for Congress to design a better way. Another close-to-home example involves WEA Trust, a health insurance carrier for many public employees, and Kiio, a young company with a novel patient engagement platform.
WEA Trust has invested $1 million in Madison-based Kiio to further develop its platform for involving patients in their own care through mobile technology and evidence-based treatment that can prevent more expensive care while yielding better results.
The insurance company will be more than a passive investor; it will become a customer for Kiio as it expands its platform from conditions such as lower back pain, joint replacement and physical rehabilitation to other protocols.
Kiio’s lower back pain screening, assessment and exercise program has already shown results, diverting costly procedures such as imaging, surgeries and specialty visits while helping patients deal with pain and dysfunction. Because back surgeries don’t always work the first time – or at all – the process saves money and frustration for all involved.
“We see the Kiio platform as becoming an engagement tool for our members across a broad spectrum of their health needs,” said Michael Quist, president and chief executive officer for WEA Trust. “It’s really limitless in terms of how it can be used to engage with patients.”
It’s also an example of how health care is moving from a bricks-and-mortar model that assumes all care takes place within a clinic or hospital to a future in which patients can get care where they work, at home or anywhere else that technology allows them to take an on-demand role in their own health.
WEA Trust was born in 1970 as an in-house insurance company for unionized Wisconsin teachers. That model changed abruptly with the passage of a 2011 law that eroded the power of the teachers’ union and put WEA Trust in “survival mode” for a few years. It has returned to firm financial footing by focusing on health insurance and functioning as a Voluntary Employees Beneficiaries Association, which exists solely to serve its members.
Because WEA Trust isn’t aligned with a specific health-care system, it is free to negotiate with many providers. The reimbursement strategy for the Kiio platform will rest on persuading a health-care provider that it works and can control costs while ensuring quality. For example, a pilot program might involve waiving co-pays on a back surgery if the patient follows the Kiio protocol first.
“We want to be at the forefront of figuring out reimbursement strategies,” Quist said.
For Kiio founder Dave Grandin, the WEA Trust investment isn’t just about the money. It’s about engaging with an innovative partner.
“We believe we’ve working with a partner that has a vision about the future of health care, not only in terms of managing costs but in enhancing quality and helping patients,” Grandin said. “For a young company like Kiio, that’s a great fit.”
Innovation in health care has been slow to come in some quarters, but information technology, patient choice and the need to control costs is accelerating change. That process will continue, with or without Congress.