Adding a Master’s in Public Health to My FSA

By Carol McCall, FSA, MAAA, Principal, Health and Analytic Innovations

Some people think I’m a glutton for punishment.  That’s their reaction to hearing I’ve gone back to school.  They say: “Wasn’t getting your FSA enough, with its years of studying and grueling exams?  Surely there’s something else you can do with your time.”  My response, when I’m not busy studying policy, epidemiology, biostatistics, or behavior change: “Yes, there is something else I can do, and adding a Master’s in Public Health (MPH) to my FSA is going to help me do it!”

U.S. healthcare is in the midst of a massive reshaping.  It is rapidly evolving toward a value-based system centered on individuals, prevention and the management of chronic disease.  Reform is driving unprecedented innovation and care that aligns with – and is paid based on – its impact on people’s health.  It also brings unprecedented challenges, with threats to long-established competitive advantages, shifts the balance of power, brings waves of new entrants, and exposes fundamental gaps in capabilities and knowledge.  The net result will be a significant redesign of the industry – where profit pools lie, who gets them, and through which business models – that will disrupt nearly every aspect of how care is organized, delivered, measured and reimbursed.

This new paradigm cannot be overstated.  We need to master new technologies, competencies and skills which will demand remarkable changes in how we think and practice.  We must learn to prize outcomes over activity, proactively address the needs of individuals and populations, replace our parochial concepts of profit and risk, and create and exchange information in a culture of shared responsibility.

While such disciplines are becoming the new table stakes, they will only succeed when value-based payments are integrated with the ability to systematically produce better outcomes and used to improve the health of individuals and populations.

Among the key disciplines to achieving success is big data analytics.  The healthcare industry’s traditional analytics and risk stratification methods are simply inadequate.  They return little in the way of guidance on what actions to take, and are incapable of systematically delivering outcomes.  Big data will transform the nature and role of observation, ignite innovations, and revolutionize the creation, diffusion and use of measure development.  Healthcare’s winners will be determined, at least in part, by who cashes in on this observational gold rush.

Another key discipline in this transformation will be the art of health promotion.  This will require us to integrate social sciences and the psychology of change, where these sciences become as important as the biomedical ones.  Even more, it will demand our deep appreciation of health’s key determinants, many of which lie entirely outside the care system, yet are more powerful determinants of outcomes.  Unfortunately, the industry’s business models don’t make investing in their improvement economically rational.

Getting my MPH adds this knowledge and deep appreciation to my actuarial skills, and allows me to make an important contribution to this effort.  I want to create innovations in actuarial-sound business models that make it economically rational to invest in health’s key determinants so we can expand our traditional notions of health, care, community and sustainability.

Then we can truly transform healthcare. It’s a journey that begins with health as its destination, and is guided by measureable improvement, sustained by strong leadership and a commitment to innovation and learning.

Gotta run!  I’m late for class.

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