Interviews

If accountable care organizations (ACOs) are going to be successful, they need to learn from another and have meetings like the ACO & Emerging Healthcare Delivery Coalition's Spring Live Meeting, being held April 28-29 in Scottsdale, Arizona, to exchange good information, explained Michael Chernew, PhD, co-editor-in-chief of The American Journal of Managed Care. Dr Chernew will also sit on a panel discussion about the future state of healthcare in the United States during the ACO Coalition's meeting.

One of the greatest challenges for the healthcare industry as it moves to value-based payments is shifting from a short-term to a long-term mode of thinking, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.

Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts, discusses consumer reactions to high-deductible health plans, which ask them to shoulder more of the burden of the cost of their healthcare.

Patients encountering high deductibles regarding medication in their Affordable Care Act plans can seek assistance from drug manufacturers by using copay programs, said Daniel J. Klein, president and CEO of the Patient Access Network Foundation.

Implementing an accountable care organization well without having gone through the process of getting patient-centered medical home designation is a struggle, Jill Watson, MBA, chief executive officer of The Kansas City Metropolitan Physician Association, said at the National Association of ACOs Spring 2016 Conference.

Changes with insurance products have led to more costs being shifted to consumers and they are having very mixed emotions when faced with high-deductible health plans, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

Patient-Centered Diabetes Care (PCDC) is important because it provides a venue to share new knowledge and to meet different stakeholders that impact diabetes care, explained Robert A. Gabbay, MD, PhD, FACP, chief medical officer of the Joslin Diabetes Center, chair of PCDC, and editor-in-chief of Evidence-Based Diabetes Management.

Hurricane Katrina revealed the gaps in public health services in New Orleans, especially for those living in poverty, said Charlotte Parent, director of health of the New Orleans Health Department.

Scottsdale Health Partners has improved coordinated care on both a physical and a virtual level through the creation of a secure texting connection for real-time collaboration, James Whitfill, MD, chief medical officer of Scottsdale Health Partners, explained at the National Association of Accountable Care Organizations’ Spring 2016 Conference.

Florida has not been very good with healthcare cost transparency in the past, but there have been many new programs and tools introduced in order to remedy that, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

The move to value-based payment is going well, but the real work has to be done on the care transformation side, Farzad Mostashari, MD, co-founder and chief executive of Aledade.

How new technologies like mHealth and wearables may affect insurance providers and patient costs, according to Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare.

Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future, discussed patient access to expensive treatments and the barriers to improving transparency.

Many consumers don’t understand high-deductible health plans and how all the components involved operate within that plan, said Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts.

As more attention has been drawn to high-cost drugs, the Institute for Clinical and Economic Review has introduced a focus on drug pricing in its reports, explained Steve Pearson, MD, MSc, FRCP, founder and president of ICER.

Getting patients access to their own data is a good thing that will increase engagement, but it is important that improving access to data will create cohesive care for the patient and not lead to fragmentation, said Julia Adler-Milstein, PhD, assistant professor at the School of Information and the School of Public Health at the University of Michigan.

Insurer consolidation results primarily in higher premiums, and that the advocated benefits of these mergers has yet to be proven, according to Sarah Lueck, senior policy analyst from the Center on Budget and Policy Priorities.

Chip Kahn, president of the Federation of American Hospitals, discusses the future of the Affordable Care Act, and the importance of coordinated care.

Any attempt at public health outreach is unlikely to succeed without involving community leaders, said Charlotte Parent, director of health of the New Orleans Health Department.

Experts say it all the time: healthcare is local. That makes it really important to involve employers and local communities that know best the challenges consumers face, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

Bruce Gilbert, executive director of the Silver State Health Insurance Exchange in Nevada explains how the exchange has targeted a more specific audience for enrollment and how the state has benefited from having a state exchange.

Martin Shkreli and Turing Pharmaceuticals are not the only instance where a previously inexpensive generic drug increased in price by more than 400%, said John Bennett, MD, FACC, FACP, president and CEO of CDPHP.

Having a state exchange has allowed even those in the most remote locations of New Mexico to gain assistance with their insurance, said Amy Dowd, CEO of beWellnm.

It is important for consumers to be actively engaged in re-enrolling for health insurance rather than relying on auto-renewal, explained Anne Jessup, senior director of digital channels at Florida Blue.

The financial assistance the Patient Access Network (PAN) Foundation provides patients is an important part of the safety net and happens in a way that doesn't influence how patients get treatment or what products they use, explained Daniel J. Klein, president and CEO of PAN.

Healthcare consolidation must be accompanied with integration of care in order to be successful, explained Robert Nesse, MD, the senior director of Policy and Payment Reform at Mayo Clinic.

When employers only offer high-deductible health plans, they reduce costs by reducing utilization. However, consumers reduce their use of essential as well as nonessential services, which is sub-optimal for their long-term health, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

The newly proposed Medicare Part B payment demonstration met immediate criticism from some in the healthcare industry. Chip Kahn, president and CEO of the Federation of American Hospitals, is also very hesitant about the demonstration and worries that it might be premature.

Improved health technologies will help physicians better monitor patients with chronic conditions so that those patients can receive more effective care and will help build a bridge between what has been reported as effective in literature and applying it to the patient, explained Lonny Reisman, MD, founder and CEO of HealthReveal.

The idea to let Medicare negotiate drug prices has been kicked around for years, but a number of forces have prevented any legislation from being passed, explained Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future.