Similar to a situation once described in the old Pogo comic strip, the U.S. healthcare industry looks to be “confronted with insurmountable opportunities” and it is being plunged into an environment where anything can happen and probably will, according to panelists offering their thoughts on the “brave new world of healthcare” Saturday at the American Medical Group Association annual conference in Orlando.
Donald Fisher, AMGA's president and CEO, was the moderator, and he began the program by asking the panel to offer their views on the direction where healthcare is headed in the “long term” and then acknowledged that, in the current environment, “long term now is one to two years.”
Rich Maturi, senior vice president with Premura Blue Cross (a Blues plan for Alaska, Oregon and Washington state), echoed Fisher's comment by noting that there will probably be more change in the next five years than the panelists have seen in the their entire careers.
Maturi predicted that the federal budget deficit will be a driver of government healthcare policy and, although it appears states are not ready, health insurance exchanges will be implemented—if only because there is so much political capital invested in them.
“It could be rocky, it could be delayed,” he said. But “it's coming one way or another.”
Dr. Robert London, national medical director for Walgreens, commented on how his company has formed three accountable care organizations, and he told the audience to expect Walgreens—now a major player in the retail clinic space—to partner with their groups to help decrease emergency department visits.
"We're going to have strange bedfellows in the next few years," London said.
Commenting on the 320 or so accountable care organizations that have been formed, Dr. Robert Nesse, CEO of the Mayo Clinic Health System, noted how "there isn't any one right model" for ACOs.
"The model is not yet defined," Nesse said. He predicted those that will be successful will have financial alignment, alignment of purpose and a strong physician contingent.
"If you don't have a network of providers, don't bother," he said, adding that health information technology system is also required.
Nesse noted a recent report that said half the hospitals in the new ACOs are not even able to share performance data. He compared that to a fire engine racing up to a burning building and having the chief instruct the team to run into the fire because "there might be a hose in there somewhere."
Yet, later Nesse noted that he's "pretty optimistic" that there will be positive outcomes for healthcare transformation and urged AMGA members to be agents of this change.
"Become a reformer, become an activist," Nesse said. "Create a smarter healthcare system."
John Rother, a former AARP strategist and now the president and CEO of the National Coalition for Health Care, called on AMGA members to tell their stories to Congress and educate federal policymakers that it is possible to provide better healthcare at lower costs.
"You in this room represent the greatest hope in making progress," Rother said.