AHIP: America's Health Insurance Plans Meetings

Cindy Bjorkquist, Director of Wellness, Care Management and Health Promotion Programs Development, Blue Cross Blue Shield of Michigan, discusses Blue Cross Blue Shield of Michigan's Total Health Improvement Strategy.

Day 1 of the America's Health Insurance Plans Fall Forum 2012 featured a pre-conference workshop on patient engagement strategies to promote wellness in a consumer-driven marketplace. Presenter and moderator Jen Cressman, Vice President, Strategic Accounts, Krames StayWell, centered her discussion on the design of effective communication strategies and how to attract and engage consumers while also fostering loyalty.

Check out photos from America's Health Insurance Plans Fall Forum 2012. The meeting is being held at the Renaissance Hotel in Chicago, IL, from December 3-5.

Healthcare is in the midst of a shift toward more patient-centric and accountable care; as a result, time- and resource-constrained providers are embracing new and innovative models for delivering and organizing care.

Len Nichols, PhD, Professor of Health Policy and Director, GMU Center for Health Policy Research and Ethics, College of Health and Human Services, George Mason University, says that if states do not expand their Medicaid programs half of the uninsured will continue without coverage. States will continue to pay for healthcare inefficiently while patients receive suboptimal care.

Although there are contentions regarding its mechanisms, health policy and managed care authorities agree that the ultimate goal of healthcare reform is to increase access, improve quality, decrease costs, and measure progress. The initiative of further integrating digital health systems and implementing health information technology continues to receive substantial support and growth in a positive direction.

Peter Cunningham, PhD, Senior Fellow and Director of Quantitative Research, Center for Studying Health System Change, says that delivery systems should be moved more towards care management in order to deal with the high levels of wasteful care and emergency room use associated with Medicaid.

Robert Berenson, MD, FACP, Institute Fellow, Health Policy Center, Urban Institute, thinks that new healthcare delivery models are inevitable due to the behavior of physicians and providers who have abused fee-for-service. Dr. Berenson says that there has been unacceptable growth in the bias of fee-for-service activities, and new delivery models are necessary to improve quality and costs in healthcare.

The current movement toward healthcare reform is a multifaceted initiative that attempts to increase healthcare access and improve quality across the nation while balancing budgets and reducing current fiscal deficits. One health program that is a major component in the movement is Medicaid, and in this article, 2 health policy experts share their insight on the impact and future direction of Medicaid reforms.

Juliette Cubanski, PhD, Associate Director, Program on Medicare Policy, Kaiser Family Foundation, believes that the Medicare program overall has as much at stake in the 2012 election. Specifically, Dr. Cubanski says increasing private plan participation in Medicare and whether Medicare should move towards privatization will be some of the greatest challenges moving forward.

With healthcare and Medicare reform initiatives set in motion and garnering substantial momentum, mechanisms and programs for assessing improvement and determining quality measures have gained increased attention. In today's featured presentation, 2 health policy experts shared their insight on the current and future movement of performance and quality measurement.

Joseph Antos, PhD, Wilson H. Taylor Scholar in Healthcare and Retirement Policy, American Enterprise Institute, says people need to accept and understand that Medicare will not pay for all healthcare expenses after the age of 65. It is necessary to realistically look at other payment alternatives.

The abuse of government programs and misappropriation of limited healthcare resources contribute significantly to, and further complicate, the growing burden of healthcare expenditures and utilization in the United States. Government bodies have demonstrated a paradigm shift, embracing collaborations and implementing evolved strategies, to more effectively combat Medicare fraud.

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.

As the search continues for effective cost-containment strategies in a landscape of substantial healthcare expenditures, policy authorities are looking at Medicare reform and the Part D model for opportunities and direction. In this discussion, 2 policy experts share their insights on the progress, trends, and possibilities of Medicare Part D.

Mark McClellan, MD, PhD, Director, Engelberg Center for Health Care Reform, Leonard D. Schaeffer Chair in Health Policy Studies, Brookings Institution, talks about how to better inform providers regarding regulations and quality measures that are part of new delivery care models.

Although delivery systems are seemingly designed with beneficial intentions and streamlined utilization, a number of current practices and policies have been the subject of criticism and controversy. Two leaders in health policy shared their insights regarding these concerns and discussed the necessary steps to further improve an antiquated delivery system during changing times.

Karen Ignagni, President and Chief Executive Officer, AHIP, feels Medicare is right to take on the challenge of hospital readmissions. Ms. Ignagni also discusses how the Medicare Advantage plans have done a better job with traditional fee-for-services programs and tackling high hospital readmission rates.

The hotly debated proposition of premium support comes during a time of healthcare improvements through the Affordable Care Act and Medicare reform, which aim to combat the rising costs and substantial budget deficits resulting from an aging population and increased healthcare utilization.