Experts cite provider partnerships, telehealth, end-of-life care as means to lower healthcare costs Partnering with hospitals is essential to making best use of data; providers, payers need to rethink meaning of ‘affordable.’
Susan Morse, Associate Editor
LAS VEGAS–Partnering with providers, using telehealth, and having more appropriate end-of-life care, are among the challenges that need to be addressed to lower the cost of healthcare, according to health insurance leaders who opened America’s Health Insurance Plans’ Annual Institute and Expo Wednesday in Las Vegas.
More than ever, the consumer is at the center of healthcare, said AHIP President and CEO Marilyn Tavenner, addressing a theme explored in numerous sessions at this year’s conference.
“I believe very strongly in our role in advancing a patient-centered delivery model,” Tavenner said. “We’re in a position to translate this vast array of data. To turn it into something understandable and usable for patients.”
Partnering with hospitals is essential to making the best use of the data, according to David Bernd, CEO Emeritus of Sentara Healthcare.
“In the past we’ve had too much hand-to-hand combat,” he said. “The key is partnerships driven around data.”
The definition of affordable may be different than what providers and payers may think it is, according to Bernard Tyson, chairman and CEO of Kaiser Permanente and future chairman of the board of AHIP.
Tyson said he learned of a patient who called Kaiser to see if she could stretch out payment of a $30 bill over three months.
“When we talk about affordability of healthcare, we’re talking about everyday working people who can’t afford to pay, $30, $50, $100,” Tyson said. “We need to rethink the best way to provide and meet the healthcare needs of millions of people in country today who can’t afford what we’re offering them.”
Former GOP Senator William Frist of Tennessee is chairman of the palliative care startup Aspire Health, that helps patients and their families by identifying those who would benefit from hospice care, earlier.
Too many people are not dying comfortably or how they want to die, Frist said.
“There’s too many hospitalizations, too many trips to the ER,” he said. “It really does not have to be that way.”
Tyson and Bernd said health systems are currently managing social service needs that outside of the United States, such as in Europe, are met through a safety net of services. This adds to the cost of healthcare.
It’s key for individuals to take personal responsibility for their own health, Bernd said, citing the 42-ounce soda no one needed that was made famous in the independent film, “Supersize Me.”
Telehealth will become more common as a way to drive down costs as it makes care accessible for consumers at night and on weekends when they might otherwise make a trip to the emergency room.
“Every payer in this room will grow telehealth,” Frist said. “Over 80 percent of large employers will guarantee access.”
Physicians need to be onboard to make the new model of value over fee-for-service work.
Bernd said the incentives are not yet there for physicians.
Kaiser Permanente is the largest, nonprofit integrated healthcare delivery system in the country, held up as a model for capitation payments to physicians.
Yet Frist said he knew of no physicians who would want to make the switch to Kaiser’s model.
“Maybe the day is over for solo practices,” Tyson said, citing one possible route in the transition to integrated care. “How do we enforce incentives to lean in and work together? Rather than sit on small island, I think there needs to be more incentives to pulling the pieces together.”