Marilyn Tavenner: Affordability the Biggest Challenge Facing Insurers

Consumer and provider education plays a large role in the healthcare system’s transition to alternative payment models and value-based care, explained Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP). Affordability is the operative word, for which Tavenner expects to be insurers biggest challenge in the coming future.

Transcript (slightly modified):

What are the concerns AHIP’s members have voiced as the US healthcare system moves toward alternative payment-models and value-based care?

I think the biggest concerns are, our members are very enthusiastic about moving to this model and our members have much more experience with capitation, are paying for an episode of bundle of care, but providers do not have as much experience. So the concern is making sure that providers are educated, they have the technology they need, the consumers understand where we’re going and they’re on board.

So I think it’s really a big education process for consumers and for providers but it’s also making sure we move in a steady path and we don’t try to go there all at once and confuse people or have unintended consequences by moving too rapidly when people aren’t ready to go.

What do you think is the biggest challenge facing insurers in the next year?

Affordability, affordability, affordability. That’s going to be something you hear about. You’ll hear about it from Congress, you’ll hear about it from both presidential candidates, and you’ll hear about it from us. Pharma’s obviously a big piece of that but it’s not just pharma. It’s general services. How do we go about getting cost in line with what our economy and the public can handle? It’s a number 1 issue for consumers, understandably so.