Through the acquisition of Healthcare Technology Management Services (HTMS) in March 2010, Emdeon now offers consulting services to help payers innovate, solve problems and optimize performance in an ever-changing healthcare environment. Acting as a strategic partner, HTMS, an Emdeon Company, helps healthcare clients develop and implement technology solutions to align with healthcare trends and each client's overall business strategy. HTMS empowers payers to achieve technology-enabled transformations.
Mike Comick, HTMS co-founder, explains what makes HTMS unique and shares the company’s focus for 2011 in this question-and-answer session.
Q. How did HTMS get started and what was your vision for the company?
A. Mike Weiher and I started HTMS in 2000– each of us has more than 25 years’ experience as healthcare consultants. Through the years, we have seen demands for healthcare consulting change. In response, we wanted to create a company that offers productive, experienced staff with specific skill sets and expertise that work variable lengths of engagement to meet particular client requirements. Our strategic approach includes reality-based interventions with practical solutions and measurable outcomes.
Q. You two are healthcare veterans! How does HTMS differ from other consulting companies?
A. We reduce the risk inherent to consulting by getting the people a payer really needs to do the job. We make sure our consultants have the specific expertise a payer wants and are engaged only at certain times, when the payer needs them. This helps us keep roles competitive and minimizes excess costs.
Another thing that makes us different is our employee model. We have 80-110 people in the field…a 40/60 ratio of employees to contractors. Our consultants have deep health industry knowledge. They have experienced a lot of the challenges organizations face, so they understand that payers may have limited time and resources, out-of-date systems, antiquated processes and diverse perspectives.
Q. Targeted staffing and optimal efficiency must be especially popular with payers these days. Which successes make you especially proud?
A. We focus on healthcare technology and operations at the executive level. As numerous regulatory and market‐driven healthcare IT changes converge, payers have to assess their existing platforms and respond to these changes. HTMS specializes in researching and assessing the healthcare IT software and service vendor market for “best-of-breed” solutions. Our leadership team has a unique blend of experience, including senior executives from healthcare organizations and leading market research firms.
Key Focus Areas Include:
• Core claims and administrative systems
• Care management
• Automated member acquisition
• Healthcare reform
-5010
-ICD-10
-MLR
-Meaningful Use
-Health Benefit Exchange
Q. Those are all very important topics for payers. How do you typically engage a payer client?
A. Our goal is to determine what the client wants– to peel the onion, so to speak. We consider education and market awareness to evaluate how a particular payer compares to its peers, and establish what it would take for the payer to compete with its leading competitors. Then we assess whether the client is willing or able to commit resources– financial, system and time- or if they can procure what’s needed to reach the top in that market. Once we’ve determined that, we analyze the payer’s strategic plan and identify gaps. Afterward, we implement and execute, testing all the systems and applying industry best practices.
Q. How do you evaluate a payer’s peers?
A. Each month HTMS distributes a survey with 8-15 questions about critical issues plans face today. The responses we receive provide benchmarking information and help us assess how payers are faring in a certain area, such as ICD-10 preparedness. Once we aggregate the data, we create a summary of our findings, which we share in a knowledge brief. We send a link to these online results when we survey payers about the next month’s topic. HTMS has conducted the surveys for years and has gained valuable insight and perspective into the payer market. We look forward to expanding the surveys and building our recipient list.
Previous surveys covered topics such as:
• Program management and organizational prioritization
• ICD-10 readiness among health plans
• Health plans struggling with 5010 compliance
Q. The survey feedback sounds especially useful. But, are there privacy concerns?
A. No. Survey responses and results are shared, but no proprietary information or identifying characteristics are given. The information gleaned from these surveys is NOT used for sales, but rather to give HTMS better insight into the payer marketplace. Interested in participating in the HTMS Executive Survey program? Email research@htms.com and request to be included in our next survey.
Q. That will likely reassure our readers. How will HTMS help payers respond to recent legislative changes in healthcare?
A. In light of ongoing healthcare reform, regulatory changes and the consumerism trend, payers need help assessing their current IT strategies– now more than ever. The HTMS team provides strategic support of technical remediation, such as the transition to the new version 5010 and pharmacy D.0 transaction formats, through the delivery of education and training workshops. For example, HTMS can help clients identify the impact of changes to workflow, systems, coding and clinical guidelines they will face in the transition to new ICD-10 code sets.
Q. ICD-10 impact is at the top of many payers’ concerns. What’s one area you’re passionate about personally?
A. While my coworkers at HTMS recognize me for my healthcare expertise, I also get a lot of attention for my love of the New England Patriots. With HTMS based in Indianapolis, Indiana, home to the Indianapolis Colts, my choice of teams baffles a lot of my Colts-leaning coworkers. They do, however, enjoy debating the topic with me during football season—or just about any time!
Q. Well, that can certainly divide an office! What’s your primary focus for 2011?
A. The Patriots starting the season off strong! Oh, you mean at HTMS? The evolution of healthcare reform and its subsequent implications for payers. We’ll start by evaluating a payer’s IT portfolio management systems to determine whether their technology and/or internal systems meet new and future requirements. Then, we’ll establish remediation and system replacement and, if applicable, recommend system and organizational investments.
We plan to pay special attention to:
• Commercial plans
• Traditional Medicaid-only plans
• Specific healthcare reform issues in CA and MA
For more information about HTMS, an Emdeon company, including survey results and white papers, visit www.HTMS.com.
Michael Comick, Partner
As principal and co-founder of HTMS, Mike Comick leads HTMS' business development initiatives and industry intelligence and analytics practice while directing automated member acquisition and care management service offerings. He focuses on strategic consulting services, including IT and business planning, system assessments and procurements, and implementation services. Previously, Mr. Comick was a vice president with First Consulting Group's Los Angeles office, specializing in core claims and administration software applications. He joined FCG after working with Charles J. Singer and Co./Gartner Group as the practice leader for core system market research. In that capacity, he published the ‘Managed Care System Vendor Guides,’ the ‘Managed Care System Win/Loss Analysis’ and the ‘HMO MIS Budget Report,’ a comparative analysis of the leading managed care systems in the industry today. Using this analysis, Mr. Comick facilitated numerous workshops and education sessions with both the payer and at-risk provider markets. He has a degree in economics. When he’s not working, Mike collects and wears a lot of Hawaiian shirts—and enjoys greeting colleagues with an enthusiastic, pirate-style “Arrrrrgggghhh!”, a tradition that began at a company meeting several years ago and remains today.
An Inside Look at HTMS, Emdeon's Newest Payer Solution Offering
