In­flu­encers: Shap­ing the Fu­ture

Mark Ganz Andy Slavitt Mar­i­lyn Taven­ner

Modern Healthcare - - CONTENTS -

Mark Ganz

Pres­i­dent and CEO Cam­bia Health So­lu­tions

The health­care in­dus­try is un­der­go­ing a tec­tonic shift, not be­cause of the Af­ford­able Care Act, but be­cause con­sumers are de­mand­ing the straight­for­ward, trans­par­ent re­tail ex­pe­ri­ence they en­joy in other as­pects of their lives. To meet their ex­pec­ta­tions, we have a his­toric op­por­tu­nity to cre­ate seam­less, end-to-end health­care ex­pe­ri­ences.

To­day, our in­dus­try is not sig­nif­i­cantly at­tuned to in­di­vid­u­als and their fam­i­lies. The hard re­al­ity is we have a long way to go. I am an op­ti­mist and am en­er­gized by the grow­ing mo­men­tum to­ward con­sumer de­sign in our in­dus­try. How we struc­ture the eco­nomic model is im­por­tant, but not the only fac­tor. The cur­rent un­der­ly­ing cul­ture of health­care is to solve for the in­sti­tu­tions and as­sume those we serve will ap­pre­ci­ate the an­swer. If we do not trans­form our cul­ture, we will re­visit and put new names on old mod­els.

I am con­vinced con­sumers will re­ward in­no­va­tive com­pa­nies that em­power their health­care ex­pe­ri­ence. Ul­ti­mately, those who suc­ceed will deeply lis­ten to the con­sumer, ap­ply their imag­i­na­tion to what they have heard and cre­ate high-value so­lu­tions that help peo­ple nav­i­gate through sick­ness and in health.

Andy Slavitt

Act­ing ad­min­is­tra­tor CMS

I had a physi­cian tell me re­cently he has been wait­ing for pay­ments to catch up to how he prac­tices medicine. We all want our payment sys­tem to pay for what we value. At the high­est level, that’s easy. It’s all the things we want from our own health­care ex­pe­ri­ences—high qual­ity co­or­di­nated care that ties the frag­mented sys­tem to­gether for us and al­lows us to get back to our lives. But good in­ten­tions too of­ten go awry in health­care. Add sev­eral pay­ers, each with their own ideas of mea­sure­ments, each us­ing their own sys­tems and all of the sud­den we’ve over­whelmed our most pre­cious re­source— the time our physi­cians spend with us. That’s why we fa­vor ap­proaches that pro­mote the physi­cian-patient re­la­tion­ship, like med­i­cal homes, and en­cour­age the play­ers in the sys­tem to work as a team, like mak­ing one bun­dled payment for an en­tire episode of care. We can all agree that pay­ing for what works is smarter, but only if we stay con­nected to the real im­pact on patient care.

Mar­i­lyn Taven­ner

Pres­i­dent and CEO Amer­ica’s Health In­sur­ance Plans

If we are to have a health­care sys­tem that is sus­tain­able for fu­ture gen­er­a­tions, we have to first rec­og­nize that be­ing a health­care con­sumer is dif­fer­ent from be­ing a pur­chaser of any other prod­uct. Health­care is not the same as buy­ing a car—it’s not a sin­gle trans­ac­tion, but rather a se­ries of transactions, each con­di­tioned on the ones that pre­ceded it. That’s why we must fun­da­men­tally change the way we pay for med­i­cal care. This means leav­ing be­hind the an­ti­quated fee-for-ser­vice model of health­care and mov­ing in­stead to­ward a val­ue­based sys­tem where value and out­comes are linked to­gether. Health plans are at the fore­front of mov­ing for­ward with al­ter­na­tive payment mod­els in both the com­mer­cial mar­ket and pub­lic pro­grams, and it’s these col­lab­o­ra­tive ef­forts be­tween health plans and stake­hold­ers across the health sys­tem that pro­vide tax­pay­ers and con­sumers with the great­est value for their health­care dol­lar.

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