Businesses know what’s needed to tame costs

Modern Healthcare - - COMMENT - By Katie Mahoney and Jennifer Pierotti Katie Mahoney is ex­ec­u­tive di­rec­tor of health­care pol­icy and Jennifer Pierotti is se­nior man­ager of health­care pol­icy for the U.S. Cham­ber of Com­merce.

Health­care costs are un­sus­tain­able, and even sup­port­ers of the Pa­tient Pro­tec­tion and Af­ford­able Care Act con­cede that the law will not rein them in. The grow­ing bur­den of our ag­ing pop­u­la­tion, lost pro­duc­tiv­ity from chronic con­di­tions and dis­eases, in­ef­fi­cien­cies in the de­liv­ery of care, and mis­align­ment of in­cen­tives in pay­ing for health ser­vices are overwhelming. As we tackle these chal­lenges, cues should be taken from the in­no­va­tions de­vel­oped by the pri­vate sec­tor to con­front these same chal­lenges.

Af­ter all, businesses have grap­pled for years with many of the same is­sues. What is the likely cost and out­come of a par­tic­u­lar health­care ser­vice? What op­tion would be best in a given situa- tion? How much pro­tec­tion is ap­pro­pri­ate to cover po­ten­tial health­care costs? In try­ing to find an­swers for our en­tire sys­tem, con­sider the so­lu­tions that many businesses have de­signed and of­fered to their em­ploy­ees. This is where the U.S. Cham­ber of Com­merce be­gan its ef­forts to iden­tify a path for­ward. Businesses have long pro­vided in­sur­ance cov­er­age, pay­ing for health­care ser­vices for mil­lions of Amer­i­cans, so they have a vested in­ter­est in bet­ter health for all. It is clear what has worked and where bar­ri­ers ex­ist. Based on this, we know what is nec­es­sary to en­sure that these suc­cesses can be more widely re­al­ized.

As em­pha­sized in our Health Care So­lu­tions Coun­cil re­port re­leased in 2013, the pri­vate sec­tor has many strate­gies on how to pro­vide mean­ing­ful in­for­ma­tion on the cost and qual­ity of ser­vices and providers; pro­mote high-value pro­grams that im­prove health and con­trol un­nec­es­sary costs; of­fer a va­ri­ety of in­sur­ance op­tions, pro­mot­ing flex­i­bil­ity; im­prove co­or­di­na­tion be­tween Medi­care and Med­i­caid; and re­struc­ture Medi­care ben­e­fits to en­cour­age ef­fi­cient use of ser­vices.

To ad­vance in­no­va­tion and achieve these goals, we must look at what has been ef­fec­tive in the past and what has sti­fled in­no­va­tion. Health­care re­form did not start with the ACA and can­not end with its im­ple­men­ta­tion. Let’s iden­tify what has worked, fix what has not, and re­al­ize that flex­i­bil­ity and col­lab­o­ra­tion are crit­i­cal in mov­ing for­ward.

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