Healthcare Reform Progress Is Focus of National Summit

Leading Experts Share Achievements, Innovations, Predictions

Napa, California—September 15, 2014—Leading futurists, health system administrators, and physicians recently convened to discuss U.S. healthcare reform progress at a forum hosted by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer.

Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company, kicked off the company’s 10th annual Executive Advisory Board meeting—a one-day gathering of nearly 100 industry experts from across the nation—by noting that “the challenge facing the profession is to provide healthcare ‘better, faster, and cheaper.’ It is a significant accomplishment to do any two of these objectives, and a daunting challenge to achieve all three, but that is the task before us.”

Keynote speaker Jeff Goldsmith, PhD, president of Healthcare Futures, Inc., noted that the main problem the nation faces is not one of rising healthcare costs, which are standing still when adjusted for population growth and inflation. The problem is affordability.

“Even with health reform, we haven’t really changed the issue of the people who can’t afford to use our services even with their health insurance coverage,” Goldsmith said. “The very large number of people who can’t afford to use the healthcare system is a very significant drag on the demand for our services.” Goldsmith said one of the tough policy decisions we face is how to make the experiences patients have more affordable.

To make healthcare better, Goldsmith said that “clinical excellence will come from culture and leadership from the top,” where care teams are empowered to eliminate waste, reduce costs, and improve clinical processes at the patient level.

Telemedicine Key to New Delivery Models
Telemedicine is a means to reduce costs, provide on-demand care, and improve clinical processes, according to panelists discussing innovative approaches to delivering healthcare. In the panel discussion:

  • Til Jolly, MD, chief medical officer, Specialists on Call, noted that telemedicine services are being provided to healthcare institutions nationwide to meet the demands of patients for immediate access to specialists; the latest, high-tech medicine; and a limited price.
  • Sarah Elizabeth Pacini, RN, JD, vice president of risk management and insurance, Advocate Health Care, discussed a successful implementation of telemedicine in the ICU that improved quality, decreased mortality, and reduced costs.
  • Matt Thorne, chief operating officer, Carena, Inc., noted that telemedicine addresses dissatisfied consumers paying more for healthcare but not getting a better experience.

Systemic Approach Best for Managing Population Health
The cost savings discussion continued with presentations on population health management. A new population health taxonomy was presented that divides any large population into four biologic cohorts: healthy patients, asymptomatic/early chronic patients, patients with full-onset chronic disease, and patients with complex episodes. Specific population management strategies and perspectives were shared:

  • Erika K. Johnson, MHSA, senior director of strategic research, University HealthSystem Consortium, emphasized that while the overwhelming majority of healthcare spending is unavoidable, it is manageable. “To reduce the healthcare spending in the U.S., we really need to manage patients with full-onset chronic diseases and complex episodes,” she stated. Patients in these two cohorts make up less than 5 percent of a commercially insured population but account for over 50 percent of the costs, she noted.
  • C.R. Burke, president and CEO, St. Joseph Heritage Healthcare, stated that the key to population health is finding like-minded organizations in order to deliver the right care, at the right time, at the right price.
  • Bill Gil, vice president and CEO, Providence Foundation, Southern California, said population health management “relies on group dynamics where electronic health records and physician interactions allow teams to focus on the overall care of a patient, not the current episode.”
  • Tawnya Bosko, senior manager, The Camden Group, outlined a performance bonus program at a Midwest physician-hospital organization where physicians were traditionally compensated by volume. The group implemented a performance bonus program with components like lab turnaround time, locked notes, meaningful use, clinical measures (as defined by HEDIS), and patient satisfaction. The combination of a withhold and contributions from major insurance partners made up the bonus pool. “This was a starting point in the transition to population health and payment based on value,” she said.

“We are proud to gather the vanguard of American medicine at our annual Executive Advisory Board,” Dr. Anderson said. “This group has great work to do—and the vision, commitment, and will to do it. We look forward to continuing our partnership with these experts in support of our mission to advance, protect, and reward the practice of good medicine.”

About The Doctors Company
Founded and led by physicians, The Doctors Company (www.thedoctors.com) is relentlessly committed to advancing, protecting, and rewarding the practice of good medicine. The Doctors Company is the nation’s largest physician-owned medical malpractice insurer, with 75,000 members and $4.3 billion in assets, and is rated A by A.M. Best Company and Fitch Ratings.

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