Health Care Leaders Call for Transformative Change

Calls demanding health care reform are growing stronger, and the leaders of the industry must recognize that it is time for change. Ingenix Chief Executive Officer Andy Slavitt told 650 attendees at the Ingenix Health Care Technology Conference May 13 - 15 that as an industry health care is failing, but right now there is a historic opportunity for real, transformative change.

However, to seize this chance, Slavitt said that the wide variety of stakeholders in the health care industry must abandon their traditional silos and begin to work together, adopting common standards of care and methods for sharing information. To date, he observed, uncoordinated efforts to provide better quality care while controlling cost have only resulted in increased complexity for care providers and consumers. Slavitt offered an example: “CEOs from health plans and pharmaceutical companies rarely have a basic dialogue on what’s coming into the drug pipeline in the next few years. That is akin to General Motors not knowing what parts Delphi is making and hoping they just fit their cars when they show up.” He added, “Instead of pursing progress, we have created barriers. Every time we take actions that don’t improve patient care, we give our critics fodder to rewrite the rules.”

It appears increasingly likely that the rules will be rewritten sooner than later. The presidential campaign has commanded a high profile for months, and the public policy swirl around health care has created at least seven serious reform proposals. At the Ingenix conference, former Senate Majority Leader Tom Daschle told a group of health care thought leaders that the next president will have a better opportunity to win support for a reform package than the Clinton administration did. Since that failed effort in 1993 and 1994, much has changed. But Senator Daschle observed that many of the same barriers remain, including the complexity of the health care system, the lack of transparency and the prevailing myth that the United States has the best health care in the world. “The reality is we have islands of excellence in a sea of mediocrity,” Daschle said.

A vocal supporter of the Obama campaign, Senator Daschle’s own proposal calls for creating a health care board that would work much like the Federal Reserve Board does in overseeing monetary policy. His ten-step plan to create better value in health care includes providing universal coverage; increasing focus on quality through evidence-based medicine; expanding information technology to reduce administrative costs; and creating a new health care infrastructure.

As part of another discussion on health care reform, Slavitt called on a panel of industry experts to offer advice for the next president. The panel included providers, payers and those involved in health care reform from a variety of political viewpoints. Among the suggestions for the first 100 day agenda:

• Install episode-based reimbursement
• Repeal all Stark laws
• Outlaw certain physician conflicts of interest
• Provide universal coverage
• Nationalize insurance coverage rules
• Address tax parity
• Create a Federal Reserve-like oversight structure
• Promote early health education
• Require electronic medical record (EMR) adoption within three years

Slavitt observed that with the imminent change in leadership, “everything is on the table” regarding how insurance is written, from who is covered, to what gets covered, how care is paid for and how much is paid.

While the political debate continues, many say the health care industry shouldn’t wait for the government to force change. Slavitt called for a renewed focus on basic, yet vital issues, such as enhancing the value of the time a patient spends with his or her doctor. Improving that relationship and making those 15 minutes of interaction more effective is critical, and one way to accomplish that is through optimized information. According to Slavitt, “In the right place, at the right time, information can be the most powerful medical tool.”

To address this need, Slavitt announced the creation and launch of the Ingenix Model Office program. Partnering with health plans and active physician practices, Ingenix will help modernize the physician / patient experience, first by helping patients find the right doctor for their situation, then by supplying the doctor with all the information he or she might need about the patient, from medical history and prescriptions to the latest evidence-based guidelines about medical treatments for various conditions. Each step, from booking an appointment, to verifying eligibility, to providing care and processing payment is supported and tracked to increase productivity.

According to many speakers at the conference, in general, the health care industry has been slow to adopt technology and use IT to collaborate and drive productivity improvements. That was a surprise to Steve Case, the chairman and CEO of Revolution Health, who told attendees that health care is at a tipping point. “We owe [consumers] a health care system that really is a system.”

Most agree that in the coming year, the potential for system-wide health care reform could make HIPAA, Medicare Part D and other changes of the past seem modest. Also, health care industry leaders cannot afford to sit on the sidelines waiting for reform to happen. As Senator Daschle said, quoting Nelson Mandela, “Many things seem impossible until it’s done.”

Slavitt highlighted the silver lining accompanying the turbulent times ahead. “The good news is that the work we do to advance patient value will be more greatly rewarded,” he said. “We can prepare our companies to succeed in a new health care industry.” For Slavitt, these preparations require working together to bring comprehensive, timely and accurate information to bear on the constant challenges of quality, cost and access that reach across all stakeholders in the industry. “Information is the lifeblood of health care,” he said, and urged the hundreds of health care leaders in attendance to use it “for the benefit of all of us.”

Click here to watch Andy Slavitt’s keynote address from the 2008 Ingenix Health Care Technology Conference.

Be sure to sign up for future issues of Ingenix Innovations, and visit the archive for recent issues.