Employers currently spend about $1.2 trillion on health benefits across 155 million workers. According to The National Business Group of Health’s annual study, employers rank the cost of specialty pharmaceuticals as the top driver of cost-increase. Much of this high cost is due to poor plan management and inefficient resource utilization. Reaching real improvement in health goals, financial and otherwise, has become extremely challenging for fully-insured and self-funded plans.
DataSmart Health Solutions gives companies a smarter way to provide healthcare coverage through technology and coordinated delivery solutions, providing a clear game plan with managerial oversight. They have connected analytics with interventions and achieved significant progress in lowering healthcare costs and enhancing medical care.
In a special chat with Bernard Khomenko, CEO of DataSmart Health Solutions, Mirror Review asks Bernard about his opinions regarding the present-day healthcare industry scenario. Bernard also opens up about the best-in-class services provided by DataSmart Health Solutions. Here are the excerpts.
What is the present day scenario of the healthcare industry?
Healthcare in America is under scrutiny at every level to squeeze out waste, unnecessary treatments, misdiagnoses, and inefficiency. Quality, outcomes, and value are the buzzwords describing the industry’s direction.
As outlays in the U.S.A. for healthcare approach 1/5th of Gross Domestic Product, pressures are mounting to deliver better care at lower cost, and signs of progress are starting to appear. While the total cost is still enormous by global standards, the rate of cost increases is starting to fall.
To what extent does the healthcare sector define a nation’s progress and economy? Please elaborate.
Economic data shows that healthcare costs have risen much faster than disposable income. This means that Americans are literally losing ground as more of their money is withheld to pay for the cost of their healthcare. Some data shows that as the amount of public spending allocated to healthcare increases, the funds available for other purposes, such as education, are squeezed.
Mounting costs are most-easily afforded by affluent companies and affluent employees, placing the unemployed and others at risk of not getting top quality, or even essential, care. As long as health costs continue to grow faster than the overall economy, those costs will remain among the highest priorities for the public sector as well as for private businesses.
Tell us about your company and its unique range of services. In the modern era of technology, how has DataSmart Health Solutions adapted to those changes in its working ecosystem?
Our methodology for delivering affordable, quality healthcare consists of a three-pronged approach assembling best-in-class providers, incorporating predictive analytics, and instituting individualized professional care. At DataSmart Health Solutions, we start with coordination in mind by orchestrating our carefully-selected platform partners, including CoreSource (TPA), Magellan Rx, and our proprietary technology and analytics. Our analytical platform is driven by the Johns Hopkins Medical School’s ACG system.
We have assembled our own benefit platform with national reach, and the solution is efficient for employer plans of all sizes. Once onboard, the plan’s members at greatest risk of emerging health concerns are identified. They are then contacted first by qualified clinical care coordinators who have been authorized to access aggregated claims and non-claims data.
What attracted you to start a venture in the healthcare sector?
The biggest personal attraction to participate in the creation of DataSmart Health Solutions was a desire to help employers with the rising cost of their health plans. In the recent past, most employers were merely a chorus of healthcare market participants without a strong voice. We observed the prevalent problems in US healthcare and reached the conclusion that there was too much waste and too little coordination. We saw the need and responded. Today, we continue to help employers obtain the best available health coverage for their workforce.
As a Leader of a prominent healthcare company, what role do you play in its operations and growth? How do you tackle professional crisis?
Working long hours is a given in our industry especially when one starts a company. I have the responsibility of ensuring overall enterprise success in a rapidly-changing market. We define success in terms of fulfilling our mission of delivering superior healthcare at lower cost and helping plans achieve their financial goals. Balancing the demands of work, family, and ourselves requires constant attention. I believe in the fact that “the only thing we have to fear is fear itself.” Owing to this, in my personal level, I relax through physical exercise, travel, and spend time with family, which helps me to make good decisions for our company.
How does your company stand apart from its competitors? What are your future milestones for DataSmart Health Solutions?
DataSmart Health Solutions delivers customized health plans to self-funded groups through benefit consultants who are dedicated to bringing true value-based healthcare to their clients. Our distinctive advantage consists of how we use data, and this advantage visibly manifests itself over time, after a plan is brought onboard. Our team constantly monitors claims and non-claims data. We use our analytics to spot major health problems in advance and make sure that appropriate interventions are initiated at a very early stage. We believe the best way to treat a costly, life-threatening problem is to prevent it in the first place, and our passion is to see that no one does a better job at this than we do.
Who was your source of inspiration during the start of your professional career? Whom would you like to dedicate your success?
I would like to dedicate my success to my parents and my role model, Atul Gawande, for his role in applying analytics in healthcare. My parents worked to deliver medical care for 30 years in one of the poorest financed health care systems in the world, modern Russia and the old days’ Soviet Union. My parents thought of their work as a service to society first and as a source of income second. Personally, I feel proud to share my success mantra for youngsters, which follows, “Big journeys start with small steps.”