Change Healthcare, September 4, 2018
The rise of value-based care and the ongoing evolution of healthcare technology are just two of the many topics the new CEO of America’s Health Insurance Plans (AHIP) says are front and center on his upcoming agenda.
AHIP’s Matt Eyles takes a deep dive on those subjects and more while speaking with Rob Capobianco, the head of the Change Healthcare value-based-care analytics team, as part of the Change Healthcare Episode Intelligence podcast series.
Rob Capobianco: I think it only gets better from here. But with consumer side devices and machine learning and AI who knows what the future holds. But I think it will incrementally keep building. That’s what we’ve seen in healthcare over and over and over again is we just keep taking the ideas farther.
Matt Eyles: I think that notion of incrementalism is really important as well when you think about healthcare because there are efforts out there and I’m coming back to the policy world for a little bit that would try and sort of fundamentally disrupt and change what’s happening within the healthcare system, whether it’s moving more towards a government-driven solution or sort of taking government out of it even a little bit more than it’s in there today. And that kind of massive disruption requires a lot of transition. That, it’s really hard to do that. And so thinking about incremental improvements whether it’s coverage expansion, ways that we’re improving healthcare is delivered, measurement quality, those are all really important and ways that we can make real progress over a finite period of time and see what’s working and what’s not. Because as we know, it’s been said before but I’ll say it here healthcare is complicated. So when you have that many moving parts probably an incremental approach is a lot more effective than trying to do a wholesale dramatic change. Despite all the disruption that we’re seeing now and all of the change whether it be on the technology side or what we’re seeing with Amazon and JP Morgan, Berkshire Hathaway, that they want to disrupt things as well. But it’s really hard to do it in a massive way in a short period of time.
Rob Capobianco: Absolutely. Want to be cognizant of time. I’m sure you have way more meetings going out today and into the rest of the week. So for the audience here that doesn’t get the opportunity to speak to someone like you, just sort of any final words of wisdom for the audience? Things you want to leave them with?
Matt Eyles: I think it’s important to embrace the change that’s happening in the healthcare system. When I think whether it was my own personal journey professionally or the disruption that we’ve seen in different parts of the healthcare system if you’re able to embrace the change, sort of step back for a second and say okay, we’re going to figure this out. It might be hard. It might be really challenging. But we’re going to be better when we come out the other side because we will have learned something different. I think that’s a pretty important approach when you’re tackling big problems that are of the complexity that we see in healthcare. And don’t fight it because you’ll probably lose if you do. So you’re better off trying to figure out how can you work with the hand that you’ve been dealt, embrace the change, and try and make the system better.
By Don McCanne, M.D.
Today’s Quote of the Day, “AHIP’s CEO provides us with his vision for health care’s future,” represented a non sequitur in that a discussion of the consequences of consolidation within the health care industry does not logically follow from the comments made by AHIP CEO Matt Eyles. Also the analogies resulted in an overstatement of the solidification and impenetrability that is taking place within the health care industry. Thus I am retracting the message (archived below).
Though I am retracting this particular Quote of the Day, I do want to reemphasize that delay in enacting and implementing an Improved Medicare for All is enabling the progression of structural changes that will create greater political and policy barriers to comprehensive reform. The need for reform is urgent.
By Don McCanne, M.D.
As we witness the consolidation of the health insurance industry and the medical-industrial complex into an amalgam that lays down the future health care infrastructure for America, it is instructive to hear the words of Matt Eyles, the CEO and thus the spokesperson for America’s Health Insurance Plans (AHIP), as he provides us with his clear vision of where we are headed. Read his words.
Did I say a clear vision? Well, we’d better understand what is behind those somewhat obscure words since this seems destined to be the future of our health care system.
We are witnessing an acceleration of broad-based merger activity – horizontal, vertical, upside down, and inside out. Use a little imagination on where that will lead.
Our continual delay in implementing the reform that we need is further embedding the insurance industry and other components of the medical-industrial complex into our health care delivery system such that they are becoming a fused unit that will not be amenable to changes proposed in the PNHP model of single payer. The delays in moving toward an improved Medicare for All are allowing the creation of a health care machine that will leave the entire health care system in the control of the billionaires forever. We will not be able to eliminate the private insurers because the private insurers will be an integral part of the health care delivery system. This amalgam is already rapidly fusing.
How do you remove a private, for-profit insurer from the health care delivery system when it has already become the delivery system itself? How do you reduce the administrative waste when the health care machine is oiled with profound administrative excesses? How do you negotiate prices with a gigantic mega-amalgam that simply exists, dominating all of health care, while invulnerable to the actions of bureaucrats who have mastered passivity.
Think again how private insurers, hospitals, outpatient centers, medical groups, retail clinics, pharmaceutical firms, pharmacy benefit managers, retail pharmacies, information technology, innovative alternative payment models, accountable care organizations, Medicaid managed care organizations, privatized Medicare Advantage plans, and endless other entities are merging into a conglomeration that, as several have said, has made health care complicated. Then try tackling this conglomeration with single payer. That amalgam won’t separate out, and we’ll be stuck with it.
AHIP’s Matt Eyles says, “When I think whether it was my own personal journey professionally or the disruption that we’ve seen in different parts of the healthcare system if you’re able to embrace the change, sort of step back for a second and say okay, we’re going to figure this out. It might be hard. It might be really challenging. But we’re going to be better when we come out the other side because we will have learned something different. I think that’s a pretty important approach when you’re tackling big problems that are of the complexity that we see in healthcare. And don’t fight it because you’ll probably lose if you do. So you’re better off trying to figure out how can you work with the hand that you’ve been dealt, embrace the change, and try and make the system better.”
Just work with what we’ve been dealt and embrace the change? This is the future according to the private insurance guru? The longer we sit on our duffs spouting incantations about ineffectual policies such as ACOs or a public option, the more our amalgamated health system will solidify, making it impervious to the application of sound health policy science. It may already be too late, but we really won’t know that for sure unless we act…now. Otherwise how would single payer Medicare for all stewards know where to send the check?
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