Metro Detroit Association of Health Underwriters
January 28, 2010
Healthcare CEO Roundtable
The topic was hot – health care reform or insurance reform? And we had the chance to hear from some of leading CEOs in the region:
· Mark A. Kelly, M.D. Executive Vice President, Henry Ford Health and CEO of The Henry Ford Medical Group
· Kimberly H. Horn, President and CEO, Priority Health
· Kevin Klobucar, President, Blue Care Network of Michigan (BCN)
· Mindi K. Fynke, President and Founder, Employee Health Insurance Management
· William Alvin, President and CEO, Health Alliance Plan (HAP) and Senior Vice President, Henry Ford Health System
Several hundred agents selling group health insurance gathered in Southfield to join in the conversation going on across the country about healthcare. Of special concern was the Michigan market, affected by deep economic distress.
Moderator Jeff Nielson of Blue Cross Blue Shield led the panel through a number of issues and questions.
There was universal agreement among these leaders on five main points put forth by Mindi Fynk:
· More people need to be covered by healthcare insurance
· Uninsured need access to coverage and to be covered
· Solutions shouldn’t stifle competition or innovation
· Solutions shouldn’t include tax hikes
· Healthcare reform has turned into health insurance reform
At the time of the meeting, Washington still hadn’t come up with a comprehensive bill addressing healthcare reform. But the panelists agreed that the initial goal of healthcare reform was morphing into insurance reform.
“Reform only focused on 10% o cost. We need to focus no on delivery of actual care,” said William Alvin. “There is tremendous inefficiency in the way we provide care. It is a disorganized healthcare system and bill on reform never focused on this.”
It was clear the healthcare system works in silos. Kevin Klobucar commented, “Today the coordinated care system works very independently; patient medical home (described as the next evolution of care) engages the physician and patient. The system can’t measure today the whole patient outcome and this must be focused on in the future.”
The panel agreed that what started as wholesale reform of the system in general has been watered down to a technical bill adjusting and reforming insurance. It doesn’t address the underlying problem in U.S. healthcare.
And that the problem is the current reimbursement rates are based on discrete/individual services. Physicians, to protect their practice, try and increase those volumes and, in so doing, leave less room and opportunity to focus on overall patient health.
Panel members agreed that physicians should be focusing on improving outcome, be supported on prevention tactics and getting patients engaged in taking care of their own health.
“We must figure out a way to get people engaged. Just having a prevention benefit is not enough,” said Klobucar.
The existing system supports treating disease, reimburses procedures and tests and limits the physician’s time with patients to really engage in preventative medicine. And many of our current physicians and specialists haven’t been trained in preventative medicine – it’s secondary to their own specialty and expertise.
So what we in the business are seeing that, despite current prevention programs, people still aren’t getting healthier. While insurance covers some preventative care, it’s not nearly comprehensive enough – for those covered, much less those without insurance or who are underinsured – to avoid disease, keep people healthy and on track with a healthy lifestyle.
Real healthcare reform would focus on a deeper engagement of the physician with the patient – a real partnership in individual health. But that takes time, and time is money. The current reimbursement process discourages this kind of real health partnership.
As an industry we need to step up to this challenge, become activists and be more aggressive in insisting on real, fundamental change in this country’s healthcare. “The current opportunity is now for the industry to activate. We need to more aggressive in making changes. We need to do it and not have it done to us,” said Kim Horn.
“Physicians here in Michigan are frightened; they have fewer and fewer patients and of those patients remaining less of them haveinsurance for payment. E-prescribing learning and adaptation took hold quickly here. Physician incentives can change just as easily to pay for performance. Paying for performance means a way to do the right thing and physicians recognize the value for both their patients and themselves,” said Dr. Mark Kelly.
This was a great opportunity to meet with our colleagues, learn from leaders in the healthcare field and get more acquainted with the far-ranging concerns of healthcare reform.
Conversation recorded by Don Watza, CEBS