AHIP | Strategic Alliance Partnership

After natural disasters like wildfires in California and hurricanes in Puerto Rico, leaders from an integrated healthcare system and a health plan spoke at the AHIP Institute & Expo to share their first-hand lessons on how businesses can continue their operations when disaster strikes.

A day after making headlines as he was announced CEO of the new joint healthcare company formed by Amazon, Berkshire Hathaway, and JPMorgan Chase, Atul Gawande, MD, took the stage at the America's Health Insurance Plans Institute & Expo to deliver a talk on the importance of thoughtful care, particularly at the end of life, and how it can be incorporated into a better healthcare system.

At a session during the America's Health Insurance Plans Institute & Expo, panelists representing insurers discussed the actions taken by their organizations as they strive toward health equity.

At the America’s Health Insurance Plans Institute and Expo, held in San Diego, California, June 20-22, Ezekiel J. Emanuel, MD, of the University of Pennsylvania’s Wharton School and School of Medicine, presented his “prescription for success” for improving healthcare in United States.

A CMS investigation found that almost 46% of the doctor listings in Medicare Advantage (MA) directories contained incorrect information. Officials worry that these inaccuracies could make it more difficult for seniors to access the healthcare they need.

Years after the country was sent into a tizzy over the fear of "death panels," there has been an enormous growth in palliative care in the United States, although it and hospice care are still very misunderstood by patients, said speakers at America's Health Insurance Plans' National Conference on Medicaid.

Senator Tim Kaine (D-VA) discussed Medicaid expansion, the Affordable Care Act, and politics at America's Health Insurance Plans' National Conference on Medicaid.

A decade after the introduction of the Medicare Part D program and the program has seen great success-but that may be coming to an end. Panelists debated just that and discussed rising drug costs during a session at America's Health Insurance Plans' National Conference on Medicare.

While there are reports of high patient satisfaction and well-managed costs in the Medicare program, the next 50 years will be full of new challenges, said Andrew Slavitt, acting CMS administrator, during the opening session at America's Health Insurance Plans' National Conference on Medicare.

Funding is an obvious issue facing Medicaid right now, but another is the changing demographic, J. Mario Molina, MD, president and chief executive officer of Molina Healthcare, said at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit.

There were a number of reasons why Michigan chose to expand its Medicaid coverage, and economics was just one part the decision, according to Stephen Fitton, Medicaid director at the Michigan Department of Community Health.

The quality bonus payments tied to CMS' star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America's Health Insurance Plan's National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.

As the 2014 midterm elections near, healthcare could have an impact on voter decisions and campaign efforts, Avik Roy, senior fellow at the Manhattan Institute, said at the American Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit.

The rising cost of prescription drugs, CMS initiative updates, and successes in home and community-based services for dual Medicare and Medicaid beneficiaries were discussed at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.

Health plans, providers, and consumers have to collaborate in order to bring value, Craig Thiele, MD, chief medical officer at CareSource, said at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid, and Dual Eligibles Summit.

At $531 billion, Medicaid is the second largest piece of healthcare spending and cannot be pushed off to be thought about another day, Cindy Mann, JD, CMS deputy administrator and director of the Center for Medicaid and CHIP Services, said at the America's Health Insurance Plans' National Conferences on Medicare and Medicaid and Dual Eligibles Summit.

The most recent Medicare Advantage and Part D program audits revealed that oversight of formulary administration is an area that health plans continue to struggle with, Sarah J. Lorance, vice president of Medicare Compliance at WellPoint, said at America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC.

At the America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC, Patrick Conway, deputy administrator for innovation and quality and chief medical officer for CMS, spoke on the future of delivery system reform.

Innovation in healthcare is becoming more important as the environment continues to evolve. There are a couple key components to increasing the adoption rate of new technologies and ideas in healthcare, according to Burns.

Many organizations would like to get consumers more engaged in their health. However, many programs miss the mark by lacking key features that have the potential to improve participation rates.

Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, states that hospice and palliative care programs are important in the coordination of care for patients.

Much of the focus at AHIP Institute 2012 has naturally been on the issues that affect health plans and payers. However, one session in particular focused on some of the barriers and issues that providers face in today's complex healthcare environment.

"The problem is that incentives are still not aligned. Health plans need to align incentives so that hospitals are not losing and not being counterproductive of the goals they are striving for, says Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners and Editor-in-Chief, The American Journal of Pharmacy Benefits.

The lunchtime general session at AHIP Institute 2012 on Thursday featured a couple of big name speakers: Paul Begala and Ari Fleischer, both of whom are political analysts for CNN. They spoke to a packed ballroom about the hot topics in healthcare reform and how they see the 2012 Presidential election shaping up.

In a heavily regulated market, it is becoming increasingly important for health plans to rely on innovative ideas. In order to do so, health insurers must create an organizational culture that places emphasis on flexibility and new ideas. In this session, presenters discuss some of the ways their organizations continue to break the mold in order to stay ahead of the curve.

Robert Margolis, MD, Managing Partner and CEO, HealthCare Partners, states that physicians and hospitals need to understand how to assess health and insurance risks in order to provide better care.

Karen Ignagni, President and CEO, America's Health Insurance Plans, spoke on Wednesday about the looming Supreme Court decision and how it will impact insurers.

One of the featured workshops at the America's Health Insurance Plans Institute 2012 on Wednesday was the Health Reform Advanced Studies Workshop, which was an interactive session that touched on a number of healthcare issues. Here are some of the highlights.

A focus at the America's Health Insurance Plans Institute 2012 is health insurance exchanges (HIX). With 30 million newly insured lives entering HIX in 2014, insurers face considerable risk. To assist insurers with managing this risk, the Centers for Medicare & Medicaid Services have developed 3 methods-reinsurance, risk adjustment, and risk corridors.

Sarah Thomas, Vice President, Public Policy and Communications, NCQA, states that there are 3 significant pieces of quality improvement strategies for health insurance exchanges.