Influencers: Shaping the Future
Mark Ganz Andy Slavitt Marilyn Tavenner
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.
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.
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.