3. Women Leaders in Healthcare Conference
August 7, 2012
Consensus Building in an Era of
Extraordinary Challenge
4.
5. Healthcare Leadership Council
• Coalition of leading executives from
insurers, hospitals, pharmaceutical
manufacturers, medical device
manufacturers, other sectors
• Shared vision of innovative, consumer-centered
healthcare system defined by
quality, affordability, accessibility
6. Once There Was Just One…
• Women leaders active in
HLC decision making:
– Vicky Gregg, BlueCross
BlueShield of Tennessee
– Patricia Hemingway Hall,
Health Care Service Corp
– Susan DeVore,
Premier healthcare alliance
– Adele Gulfo, Pfizer
– Patricia Simmons, Mayo Clinic
– Christine Jacobs, Theragenics
– Heyward Donigan, ValueOptions
– Colleen Conway-Welch,
Vanderbilt University School of Nursing
– Marion McCourt, AstraZeneca
7. “Scholars find that women, compared with
men, tend to excel in consensus-building
and certain other skills useful in
leadership.”
--Nicholas Kristof, New York Times
“When Women Rule”
8. Where We Need Consensus
• The direction of health reform
– Kaiser July tracking survey: 38%
favorable, 44% unfavorable
• Entitlement reform
• Deficit reduction and healthcare
• The role of medical innovation
9. Conflict in the Political World
• Elections may not lend clarity
• Presidential race will likely
leave half of U.S. unhappy
– CBS/NY Times poll:
Romney 47-46%
– Gallup tracking poll:
consistent 1-2% margin
• Obama maintains slight lead
in key swing states
10. A Closely Divided Congress
• U.S. Senate based on current
polling: 47 D, 45 R, 8 tossups
(6 D seats, 2 R seats)
– Neither party will have 60 votes
needed to pass major legislation
• U.S. House based on current
polling: 214 R, 172 D, 49
tossups
– Analysts: Majority unlikely to
change, but Democrats could
tighten margin
11. Defining Success in Health Reform
• Continuous quality improvement
• Vibrant innovation
• Eliminating health disparities
• Improved cost-effectiveness
• Sustainability
12. Where Do We Focus Our Ideas,
Our Voices?
• Implementing health reform
– Preserving the best, fixing the
problematic
• Deficit reduction that doesn‟t
undermine American healthcare
– Reforms that add value, not cuts
that hurt quality and access
• Strengthening entitlement
programs for the long run
– Understanding that the status
quo is not sustainable
13. The Best of Health Reform
• Addressing the uninsured
crisis a historic achievement
• Takes steps in fixing the
volume-not-value approach
to healthcare
– Centers for Medicare and
Medicaid Innovation
• Improved prevention and
wellness features
• Closing the Medicare Part D
“doughnut hole”
14. Health Reform Concerns to Address
• Independent Payment Advisory Board (IPAB)
– Ax to cut spending with no focus
on value or quality
– No accountability to public
• Medicaid expansion
– Low reimbursement rates present
access concerns
– Will all states participate?
• Taxes, fees and payment cuts
– Almost all health sectors take a hit
– Impact on quality, access, innovation?
15. Deficit Reduction and Health Care
• Healthcare will be a focus of budget cuts
• Simpson-Bowles ideas raise concerns
– Global healthcare spending limits
– Beefed-up IPAB
– Resurrection of the „public option‟
• Reconcile two goals – spending reductions and
improved health outcomes
16. Private Sector Providing Answers
• Companies in every health
sector demonstrating how to
improve care, curb costs
• HLC Value, Wellness
Compendiums
– Providing metric-supported
examples of cost-effective
care, disease prevention
17. Medicare Reform
• National debt rapidly • Ensure economic growth
increasing, burden for and jobs today;
future generations opportunities for
• Aging population requires children, grandchildren
more healthcare tomorrow
• Current entitlement • Maintain access to
structure cannot stand healthcare for current,
without tax future Medicare
increases, provider & beneficiaries
benefit cuts
18. Medicare’s Future
• Projected insolvency date: 2024
• Over 10,000 baby boomers
turning 65 each day
– Beneficiary population: 45.2 mil
today, 70 mil in 2030
• Medicare 3.6% of GDP today;
6.4% in 2030
• Average baby boomer couple
will pay $114,000 in lifetime
Medicare payroll taxes
– Receive $350,000 in medical care
19. Some Options on the Table
• Denial (“Keep Medicare
as we know it”)
• Provider cuts
– $575 billion in Medicare
payment reductions in PPACA
• Let IPAB do it
• De facto price controls
20. Is There a Better Answer?
• HLC Approach:
– Inject Medicare with consumer
choice and competition
– Private health plans compete
on cost, value
• Beneficiaries would have option of
staying in conventional FFS Medicare
– Cost savings generated by
competition, not price controls
or government-mandated
payment cuts
21. Consensus Building: The Tasks Ahead
• Present compelling vision
of innovation-based,
accessible healthcare
• Make clear that status
quo cannot stand
• Communicate the answers
found in new private sector
approaches
• Build agreement that cost
containment, quality
improvement are not
mutually exclusive