Interview with Miles Snowden at Optum

Date: 05.15.2013 | Zach Urbina">Zach Urbina

Miles Snowden is the Chief Medical Officer at Optum. Among his responsibilities include making sure their products meet the needs of providers and payers, as they anticipate what stakeholders will need in the coming years. We caught up with Miles at the Fall 2012 Accountable Care and Health IT Strategies Summit in Chicago, Ill to discuss the shifting landscape of ACO formation and health IT implementation.


Looking at the latest Optum/Harris Interactive survey on healthcare sustainability, we see there is quite a discrepancy between hospital executives and physicians in their willingness to accept performance-based risk. How do you interpret that? 

Miles Snowden: I think physicians and hospital executives are starting from two different places. Hospital executives I would categorize as expectant, energized somewhat, by the opportunity before them.  For example, virtually all of the executives we surveyed, some 90% indicated that they understood the concept of an Accountable Care Organization. And amongst those three out of every four believed that they would soon join, or participate, or initiate an Accountable Care Organization.

This is in contrast to physicians who I would describe as awakening. Only half of the physicians we surveyed actually recognized the concept of an Accountable Care Organization.  And of those who knew the term ACO, only half of those actually intended to participate or establish an Accountable Care Organization.  So they are starting in two different places.

In addition, each is judging their readiness to embrace new risk-based contracts differently. In the hospital executives group a full quarter of them express readiness to embrace risk in return for guaranteeing certain clinical outcomes.

In the physician group, only 12% indicated that they felt they were ready now to hold more risk in regard to producing the most favorable clinical outcomes.


Did the survey unveil any opportunities for better healthcare collaboration?

Miles Snowden:  One of the most consistent points of view between physicians and hospital executives in the survey was the concept that there was opportunity in their respective communities for better collaboration. More than 90% of executives and more than 80% of physicians agreed that there was opportunity for greater collaboration.

The term “collaboration,” however, was used in a very broad and expansive sense for the community. The question was around is there an opportunity for physicians, hospital executives, insurers, employers, and consumers in their community to collaborate for better clinical outcomes. So it is very much a broad, encompassing concept, which was largely agreed to by both. That is very encouraging.

In addition, each saw that there was opportunity for improving quality in their communities. Each recognized that there was a portion of the delivery system that was producing sub-optimal outcomes.


After spending time at the Accountable Care & HIT Strategies Summit this week, what do you feel is the most promising IT innovation that will bring the healthcare system more value and efficiency?

Miles Snowden: As I listen to dialogue around the Round Table Discussions and with the presenters, what occurred to me was the overarching understanding of the strategy of the core competencies of technology necessary to be successful in these new value-based contracts.

By that I mean, the understanding that it starts with an Electronic Medical Record that is not just installed, but it is fully adopted. Secondly, that it requires the use of a Health Information Exchange to connect disparate EMRs across a community and across a group of physicians who are often loosely aligned.

Third, that the application of contemporary analytics to that aggregated data is necessary to create a blueprint for what opportunities exist and what interventions are required.

And last, and perhaps somewhat unique to this venue has been the focus on applying new methods for population health management technology on that aggregated data that has now been analyzed. There was a lot of conversation about the application of population health management and an excellent understanding of the opportunity we have to advance clinical outcomes above and beyond prior years by putting that in the hands of physicians and allowing it to be a physician-directed population health management initiative.

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