On Friday, November 7, 2008, more than 150 health care executives gathered on the Minneapolis Campus of the University of St. Thomas to discuss the future of health care and how to seize opportunities in this new environment. The conference was developed in partnership with the firms of LarsonAllen and Fredrikson and Byron, and will be an annual event.
In the future, this year may be looked upon as a turning point in the design and function of the American health care system as president-elect Obama emphasizes health care reform as one of his top priorities. It was reassuring that many of the speakers at the UST conference reinforced the need for many of the changes addressed in the Obama plan and that many of these changes are already being implemented.
The conference focused on two major forces in the system today and how they will probably change in the future.
The Financing system
Stuart Guterman, assistant vice president of the Commonwealth Fund, provided his predictions on future changes in Medicare. Mr. Guterman is particularly knowledgeable due to his many years as a senior Medicare official. He suggested that Congress will enact much of the payment and system reform recommended by the Commonwealth Fund and included in the new president’s plan, such as programs for coordinating and integrating care, transparency, new payment incentives for excellence and a comparative effectiveness review agency.
Forest Burke, president of the Public Sector Group with United Healthcare described the rich experimentation now proceeding at the state level in many places. President-elect Obama has included an “Insurance Exchange” in his plan to assist individuals in purchasing insurance. Mr. Burke noted that this type of vehicle was being tried in many states – most prominently in Massachusetts. Another interesting trend is the aggressive regulation contained in the California reform plan, requiring both hospitals and health plans to limit their overhead costs to 15 percent of their operations. President-elect Obama does not address this directly in his plan but you can expect regulatory ideas such as these to appear in national reform.
Finally, Dr. Jeff Schiff outlined the new Minnesota Health Reform Initiative with its major emphasis on improving primary care through the creation of health care homes. The Obama plan reinforces the need for additional primary care resources in his plan with increased reimbursement, loan forgiveness, grants and infrastructure support. Dr. Schiff provided two startling research findings in his presentation:
• A 20 percent increase in primary care physicians in a state is associated with a 5 percent decrease in mortality.
• Increasing the number of primary care providers by 1 per 10,000 reduces overall spending by $684 per person per year.
The Care System
Dr. Michael Rock, from the Mayo Clinic, presented a health care reform plan that Mayo has been promoting over the past two years. It includes many elements of the Obama plan with a special emphasis on value purchasing and transparency. Mayo continues to be one of the leaders in care coordination and effectiveness within the U.S.
Mark Eustis, CEO of Fairview Health Services, described Fairview’s strategic plan in some depth with an emphasis on some of its unique elements. President-elect Obama devotes an entire section of his plan to “Promoting Prevention and Strengthening Public Health.” Fairview has already recognized this challenge and is implementing strategies to create new models of care delivery to improve the health of defined populations.
Finally, Jim Coleman, chief operations officer at the Marshfield Clinic, explained in some detail the operations improvements underway within Marshfield and their extensive use of their health information technology. The first item in the Obama plan is to increase investment in HIT, and Marshfield is an outstanding example. Because they have had their system in place since 1995, they are leveraging it very effectively to significantly improve quality and lower costs. (See a related post on Geisinger Clinic’s effective use of HIT.)
Breakout Sessions and Conference Proceedings
The conference included an overview of the current health policy environment by Senator Dave Durenberger and a number of excellent breakout sessions which focused on some of the detailed issues in health care financing and care delivery. A complete listing is available here.
The written proceedings from the conference, videos of the panel speakers and slides will be available soon on the Web site of the Center for Health and Medical Affairs.
