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J.D. Kleinke        

Medical Economist, Former Healthcare Executive & Author; Thought Leader and Pioneer in Healthcare Informatics

J.D. Kleinke is a medical economist, author of three books on the structure of the U.S. healthcare system, and a former healthcare executive. He was one of the pioneers of the healthcare informatics industry. In the 1990s, he was a principal architect in the creation and rapid growth of HCIA / Solucient – now Truven Health Analytics – from a niche healthcare data analysis firm to a leading provider of information products to healthcare organizations across the U.S. and Europe. Kleinke also helped establish HealthGrades, for which he served as Executive Vice Chairman of the Board when it was a public company.

Kleinke has been a member of the Editorial Board of Health Affairs, a frequent contributor to The Wall Street Journal, and a Resident Scholar in health policy at the American Enterprise Institute. His books include "Bleeding Edge: The Business of Health Care in the New Century" and "Oxymorons: The Myth of a US Health Care System," both of which are used in healthcare management graduate education; and the critically acclaimed "Catching Babies," a novel about the training and culture of OB/GYNs, which is currently in development as a television series by Warners Bros TV and ABC.

Speech Topics

What NOW? The US Health Care System after COVID

First, the good news: after 30 years of hype, hope, and disappointment, telehealth has finally broken through – and all it took was a global pandemic. But thanks to the pandemic, one-third of the medical workforce now wants to quit. How will your organization cope with the coming systemic shock? Will the ongoing migration of medical care to less invasive settings ease some of the burden by re-aligning where patients get their care with where and how your employees would rather work? The question is especially pressing as the demand for all health care services is about to spike, thanks to the “collateral epidemiology” of the pandemic: the medical consequences of patients putting off primary care, cancer screenings, surgeries, and other treatments for two years. Challenges, yes, but they also mean opportunities for organizational transformation in what may be the most significant structural re-alignment of health care in the US since the rise of managed care in the 1990s. This session will outline what both telehealth and traditional medical care will look like in the very near future – and organizational strategies for adapting, surviving, and thriving in the American healthcare system after the pandemic.

The Patient Is In: New Business Models for Health Care’s Digital Age

Over the past two decades, the locus of medical decision-making – via the rise and fall of “managed care” – has shifted from physician to health plan to patient. High-deductible health insurance, complex co-payment systems, and the emergence of hundreds of new digital tools for patients are conspiring to change everything we thought we knew about the economic behaviors of healthcare consumers. Payers and providers are scrambling to re-align around these changes, resulting in a series of unusual mergers, acquisitions, and a few wildly new business initiatives and models over the past few years. This session attempts to explain why. We will examine the impact of general inflation, medical cost inflation, and margin compression on health insurance market upheavals, the collateral impacts on hospitals and physician groups, the emergence of new payment models for astronomically expensive new drugs, and the potential reshuffling of different patient populations in and out of coverage. This speech is not for the faint of heart!

Risky Hospital Business 2: Remake of the 1990s Managed Care Classic

Do payers really mean it this time…or are we just partying like it’s 1999? Value-based payment, global package pricing, MACRA, ACOs, and medical homes – these are only a few of the latest attempts to correct the health system’s economic, behavioral, and organizational disorders a century in the making. The cost and quality problems that gave rise to the national managed care companies in the 1990s have not gone away, inspiring both the government and large health plans to simultaneously revisit many of those same managed care strategies. Will this second round - and double dose - of harsh economic medicine prove worse than the disease? Or are certain aspects of health care’s cost and quality problems simply incurable? How can provider organizations cope with a system that, as the government and payers attempt to re-engineer it around reimbursement, seems to yield only more chaos? This session will outline how your organization can navigate the latest attempt to use reimbursement and other payment reforms to re-engineer the U.S. healthcare system.

American Medicine 2.0: The Revolution will be Computerized

After $17.2 billion in Federal funding, the healthcare provider industry is finally computerized. Sort of. And while everyone has been busy implementing Electronic Medical Records (EMRs), there has been explosive growth in all kinds of digital tools for patients to share exquisite details about their medical conditions and experiences – with their current providers, with new providers, and with each other. New reimbursement methods and models – including insurer-paid e-visits and annual “connectivity” fees from patients – are emerging in parallel with these technologies. The one element central to the business strategies of almost all health plans and provider systems is information technology. EMRs and other information technologies are now mission-critical, as they are required to support (among other things) new payment models for hospitals and physicians for acute cases, the transfer of financial risk from insurers and the government to providers for the aggregate cost of chronically ill patients, the cost-driven re-engineering of antiquated clinical workflows, and connectivity with patients and potential patients. This session will outline how your organization can avoid the pitfalls and seize the opportunities associated with this long-overdue computerization of American medicine.

Once & Future Health Care M&A Strategies: The Best Defense is a Good -- Transaction?

Health insurers have been reacting to the inflationary spiral and cost compression of the past few years the same way they did to the last assault on their profit margins - managed care in the 1990s - with lockstep acquisitions of each other, of providers, and of businesses with often tenuous relevance to their core competencies. Payers and providers are scrambling to re-align around what many believe will be major changes in reimbursement, health insurance markets, and consumer and patient economic behavior. This session attempts to explain why! We will examine the impact of inflation and intense cost compression on health insurance market upheavals, the collateral impacts on hospitals and physician groups, the emergence of new payment models for astronomically expensive new drugs, and the potential reshuffling of different patient populations in and out of coverage. This speech is not for the faint of heart!

Books

9780692977767
Dudeville
2017

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