CEO at TTrenkle Consulting LLC
Tony Trenkle is a nationally recognized health IT executive leader. He currently leads TTrenkle Consulting LLC, which provides strategic advisory services to support clients in the IT and Healthcare sectors, both government and commercial.
Susheel: Tony, thank you for taking time out of your busy schedule to talk with us. DistilNFO appreciates it!
To start with, tell us about yourself, your career journey so far and your current role.
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Tony: I am currently work as a strategic consultant helping various government contractors and health industry organizations with their business strategies. Before my current work, I spent almost 28 years in the US Federal government working for several agencies at senior level positions, including serving as CIO at the Centers for Medicare and Medicaid Services. After I retired from the Federal Government, I joined IBM as their Chief Health Information Officer, working in both their government and commercial health areas. On the commercial side, my focus was developing go-to-market strategies for the US payer market. I worked at IBM for four years and then started my current consulting business.
Tony: There are many exciting changes occurring in the healthcare industry. Since my focus is mainly on technology, I am very excited about how payers and providers are starting to use technology innovation to create new business and consumer models. For example, the move to the value-based payments is much more effective now than it would have been years ago because technology allows us to capture and analyze vast amounts of structured but also more importantly unstructured data.
The move to the value-based payments is much more effective now than it would have been years ago because technology allows us to capture and analyze vast amounts of structured but also more importantly unstructured data.
Susheel:The whole economy is finding a new normal amid this [COVID19] pandemic. How is this impacting the payer and providers?
Tony: There are several important COVID-related impacts we have observed in the populations MBM serves:
It is having a major impact on the industry, as it has for all industries. The most obvious impacts are the growth in telehealth, changes in patient care, and greater appreciation for the role of public health. There are also major impacts on revenue flows and the need to modify patient risk profiles to reflect the impact of COVID. The biggest challenge for the industry is probably the uncertain environment created by COVID. That has impacted revenues, surgical procedures, and other normally more stable areas that allow the industry to plan and triage.
Tony: Success can be defined in many ways, but it is difficult to pick an overarching metric because of the diversity of payers. For example, many payers are for-profit, while others are non-profit. Some are traditional payers while others are provider-owned or part of a larger healthcare conglomerate. A few are national in scope, others are regional, and still others serve only a single metro area with a small number of covered lives. Much of the industry is becoming more consolidated and larger payers are increasing their overall market share. Given that diversity, I would characterize a successful payer as one who can continually evolve to meet their members changing needs and develop new business models that allow them to grow and expand their business. A failed payer is one that does not change their business model to move beyond their traditional lines of business regardless of changing government policies, technology innovation or new market conditions.
I would characterize a successful payer as one who can continually evolve to meet their members changing needs and develop new business models that allow them to grow and expand their business.
Tony: There are several types of innovation: policy, technology, and business. Each of these areas can draw from internal sources or from outside entities.
An example of a policy innovation would be moving to value-based payments but in a way that promotes outcomes that focus on key non-clinical indicators such as social determinants of health as well traditional clinical measures. The government sets the overall policy change, but the payer can be innovative in how they implement it. In technology an innovation example would be providing better ways for members to access and use their data with FHIR-based APIs. A business innovation example could be using cloud technology not just to “lift and shift” your processes but take advantage of the technology to develop new and better processes that can increase productivity, reduce errors, serve your customers better etc.
A few of the top challenges include:
- Fierce partisan politics at the Federal level leading to constantly shifting policy mandates
- Increasing pace of technology and having sufficient staff that can keep current with the changes
- Move to value-based care creates a greater need for coordination between payers and providers across multiple areas including interoperability
- Trying to understand and keep up with changing consumer needs, much of which are caused by expectations created through their B2C interactions in other industries such as retail and financial services
- Larger, more diversified competitors that are forcing more industry consolidation
- The growth in expensive therapies and drugs that are more individually tailored and potentially more effective for treating a patient with serious health conditions but often quite expensive.
Tony: The healthcare industry has seen major changes over the past ten years, and I expect even greater ones to occur in the future. Future CEOs will need to understand several things:
- Keep up with technology innovations and understand how it can be leveraged to create new business processes and change their interactions with their customers (patients, members, beneficiaries etc.).
- Understand and anticipate government policy changes and how they might impact their specific lines of business or the industry overall.
- Recognize that their industry will become more competitive and much of the competition will come from non-traditional sources that are already impacting healthcare like technology companies, retail giants, and large integrated health systems.
Even with all the changes, executives will still need the timeless essential skillsets such as the ability to think critically and analytically, effective verbal and written communications skills, empathic relationship management across all interactions, strategic thinking, etc.
Tony: America needs a better healthcare system that serves all Americans with high quality and cost-effectiveness. Only by the industry working together can we get there. Each of you plays key roles in building a better healthcare system, both individually and as part of the larger ecosystem.
Tony: Change is constant. Embrace it, learn from it, and use it to create a better healthcare for the world of tomorrow. Stay flexible and be open to new ideas and approaches; never become complacent or get caught up with your own ego. Work to promote good relationships at all levels.
Change is constant. Embrace it, learn from it, and use it to create a better healthcare for the world of tomorrow.