Challenges in health care – ranging from the far-reaching opioid epidemic, limited access to mental health services, and funding care for a large number of uninsured and underinsured Idahoans –
make it more important than ever for industry players to get the right bearings to navigate uncertain terrain.
At this year’s Idaho Healthcare Summit, more than 200 health care business leaders, industry experts and stakeholders gathered to tackle these pressing concerns and more. The two-day program, held May 21 and 22, touched on a broad array of topics, incorporating perspectives from across the health care industry.
Co-sponsored by Saint Alphonsus Health System and Blue Cross of Idaho, the fifth annual summit drew panelists that included consumers, advocacy groups, health care organizations, legislators, public health, business, education, providers, hospitals and medical centers, insurers and government entities.
Takeaways from the conference included the need to analyze data to better understand the non-medical factors that impact health; the moves toward value-based contracting with payers; reining in costs; how to tackle the ticking health care time bomb called caring for the baby boomer generation; and, as the keynote speaker advised, “to think more about partnerships – not conflict.”
Keynoter Ian Morrison, Ph.D., an author and consultant on the future of health care, gave a historical perspective on the health care system’s evolution in the past decade and where he sees it 10 years out. He calls it the most fundamental issue in the 2020 election, but said the adoption of a single-payer system is unlikely and essentially unworkable.
The reason: Americans “don’t like top-downs solutions” from the government, especially if Uncle Sam is running the health care system. Instead, he thinks a more realistic approach is an incremental move to universal coverage where bipartisan agreement from lawmakers and funders is the order of the day, and technology is employed to higher degree to bring more efficiencies to the health care delivery system.
“I would say that our best hope moving forward is to migrate American health care to one I would put under the label of ‘Medicare Advantage for All,'” said Morrison. “It tries to reconcile different values with regard to competition and the role of government, but mandates that everybody is in the system and everyone is covered.”
He added that employers, insurers and other payers and hospital systems would still be in the mix in this scenario.
Morrison was himself denied care on three occasions until the Affordable Care Act, also known as Obamacare, took effect. It was a game changer in the health care landscape, he asserted. The upshot was that commercial insurers could no longer disqualify folks like Morrison from coverage with pre-existing conditions.
The Affordable Care Act offered generous financial help to states that expanded their Medicaid programs and exchanges, bringing down the number of America’s uninsured by about 20 million people, said Morrison.
Building Obamacare was expensive and complex — billions in grants to create online markets, voluminous rules, a massive update of state Medicaid systems, and a sweeping change of state and federal regulatory roles, he noted.
“The ACA lives on in Republican hands, despite attempts to repeal and replace. We see half-hearted support from Trump and talk of shifting to block grants, which are code words for ‘less money,’” said Morrison.
Coverage expansion has undeniably helped hospitals and health systems by substantially reducing the uncompensated care burden. But the rise of high deductibles for those with employer-paid insurance has dampened demand for some primary care services and has potentially increased bad debt for physicians, who are seeing more patients with deductibles of $2,000 or more, said Morrison.
In a country that spends nearly $3.4 trillion a year on health care (about a third of which, many researchers agree, ranges from wasteful to useless), Morrison said Idaho voter support of Medicaid expansion “is good for your state” in the long run. Much of the cost for Medicaid expansion is expected to be covered by the federal government.
Idaho legislators added a variety of “sideboards” to the program, such as work requirements.
Several of these require approval of waivers by the federal Centers for Medicare and Medicaid Services, which are still pending for Idaho.