J.D. Kleinke

J.D. Kleinke Speaker Biography

Medical Economist & Author

J.D. Kleinke is a medical economist, author of three books on the structure of the US health care system, and a former health care executive. He has been instrumental in the creation of four health care information organizations; has served on the Boards of several health care companies; and spent many years advising both sides of the political aisle on non-partisan, practical approaches to health policy and legislation.

Healthcare

J.D. was one of the pioneers of the health care 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 health care data analysis firm, to a leading provider of information products to health care organizations across the U.S. and Europe. He also helped establish HealthGrades, which he served as Executive Vice Chairman of the Board when it was a public company.

Publications

J.D. 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 health care 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.

Speaker

For both consulting clients and conference audiences across the health care, medical, corporate, policy and patient communities, J.D. provides a pragmatic and often humorous look at the collision of government reform, increasing patient economic empowerment, and emerging information and medical technologies – and their combined effects on the future challenges and opportunities for today’s health care organization.

Consultant

J.D. Kleinke Speaking 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 are 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 health care system after the pandemic.

The High Price of Progress: Who Pays for Medicine's Good Bad Luck?

The majority of medical research compels the utilization of ever newer and ever more expensive drugs and other medical technologies. At the same time, the majority of actions by private and public health plans seek to constrain their use – or outright shift the bulk of payment for them to patients and their families. The result is an emerging collision course - between the march of medical science and the countermarch of medical policy - arising from often bitterly divided views about the optimal use of expensive medical resources. The turmoil in the private health care system's approach to managing health benefits and costs can be remedied through adoption of a value-based (rather than price-based) approach to pharmaceutical and other medical technology spending - and all stakeholders in the system have the opportunity to enable, rather than resist, the hard economic news associated with all of our good clinical luck.

Health Care Policy & Politics after the Republican Party Populist Makeover

For decades, health policy and legislation in the US followed a predictable script: one party wanted more regulation of health care providers and payers, more public funding for vulnerable populations, and price controls. The other party preferred to let markets, competition and consumer choice drive the system toward efficiency. The result was a classic political hybrid like the Affordable Care Act, which attempted to split the difference, and a drug industry free to charge what it wanted for its biggest breakthroughs. All of that changed in the last eight years. Now, both parties are calling for price controls on drugs, anti-trust enforcement of health care mergers, and aggressive regulation of billions in private equity acquisitions that were given free reign to roil nearly every kind of health care labor market. While the new partisan math in health policy has turned the once politically unassailable pharmaceutical industry into a political orphan, what other health policy impacts are just around the corner? Might this sudden populist majority, forged across old party lines, drive legislation previously unimaginable? Might it actually be good news for patients, nurses and doctors, difficult news for health insurers, and terrible news for the drug industry?

The Patient Is In: Health Care’s Next Economic Revolution

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. Tiered co-payments and the introduction of high-deductible health insurance, coupled with Health Savings Accounts, are ushering in the inevitable decline of first-dollar coverage by health plans and the often irrational demand-inducement behavior of consumers. How will people behave when they are confronted daily with a financial document that looks like a 401(k) plan statement - one which shrinks with every doctor visit, lab test, new prescription and refill? Everything we think we know about how consumers will behave when purchasing routine care from these new cash accounts - and about how desperately ill patients will behave when confronted with draining those same accounts when fighting a life-threatening illness - is completely speculative. This session examines key moments in health care system history and policy for clues as to what the future will hold for all of us, not just as patients, but as real health care consumers.

American Medicine 2.0: The Revolution will be Computerized

Health care has finally caught up with the rest of industry. Now, the one element central to the business strategies of almost all health plans and provider systems is information technology. These technologies are now mission-critical, as they are required to support: new payment models for hospitals and physicians for acute cases; the transfer of financial risk from insurers and the government to ACOs for the aggregate cost of chronically ill patients; and cost-driven re-engineering of antiquated clinical workflows. All of these new initiatives are highly dependent on major expansions in the availability of patient clinical data - including all lab and imaging data and related studies – along with the creation of new information flows within and across provider systems. This session will outline how your organization can avoid the pitfalls and seize the opportunities associated with this long overdue computerization of American medicine.

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, 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. health care system.