Change is one constant in health care.
That’s one inescapable conclusion from the seventh annual Cincy Magazine Healthcare Summit in early December.
The event drew more than 100 local business and nonprofit executives to the Manor House in Mason to take the temperature of health care delivery in the region. This year’s event also included the presentation of a lifetime achievement award to James E. Schwab, who retired in October after leading Interact for Health, the region’s largest health care foundation, since 2011.
The changing health care landscape was the focus of the panel discussion led by moderator Erin Hoeflinger, president of Anthem Blue Cross Blue Shield of Ohio.
One of the biggest changes on the horizon is a plan by the Trump Administration and the Republican Congress to repeal and replace the Affordable Care Act.
“It’s been a turbulent time in the health care industry and for us in the trenches trying to implement [the ACA] it’s been a bit of a rollercoaster,” says panelist Teresa Haught, chief financial officer for ArtsWave, representing employers.
Despite criticism of the ACA, she says, the law included positive elements, such as including children to age 26 on their parents’ health plans that will hopefully remain in its replacement.
Hoeflinger asked if Cincinnatians are healthier today than they were five or 10 years ago.
“It depends where you live, your income and your education,” says Judith Warren, CEO of Health Care Access Now, a nonprofit working to reduce disparities in local health care. Studies by local hospitals and others indicate those factors play a big role in local residents’ health, she says.
Dr. Michael R. Jennings, vice president and chief clinical officer at The Christ Hospital Health Network, agreed.
“I’m not sure we’re doing a very good job of anything,” he admitted, pointing to the fragmented way health care is provided.
“One of the challenges we have is a profound shortage of primary care providers,” he says. “Studies indicate with primary care, patients get better outcomes and lower costs.”
A positive development, he says, are innovative efforts on how physicians and hospitals are reimbursed, moving away from fee-for-service models and tying payments to outcomes.
“You get what you incentivize,” he says. “If you incentivize physicians to see more patients, they’ll see more patients. If you incentivize them to improve the quality of care, and do more preventative care, that’s what they’ll do.”
Technology is also reshaping health care with online physician consultations, electronic medical records and using data to shape care.
“Big data is the sexy word out there, “ says panelist Valerie Bogdan-Powers, chief business development and client relations officer with insurance and benefits consultant Horan.
Middle-market employers, using sophisticated tools, can use data to improve care for their employees.
“Tools we’re bringing to our clients allow us to take all that data and break it into simple actions.”
For example, she says, instead of just using claims data to look at emergency room usage, modeling tools can delve into what is prompting ER visits and use mapping data to locate lower cost alternatives nearby.
For employers looking to control health care costs, Haught says, constant communication with employees is essential.
”You’ve got to over-communicate,” she says.
Smoking cessation programs are a good place to start if employers want to make their employees healthier, says Jennings.
“It’s not easy to quit, but it has a big impact on employee health,” he says.