Interviews

Experts say it all the time: healthcare is local. That makes it really important to involve employers and local communities that know best the challenges consumers face, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

Bruce Gilbert, executive director of the Silver State Health Insurance Exchange in Nevada explains how the exchange has targeted a more specific audience for enrollment and how the state has benefited from having a state exchange.

Martin Shkreli and Turing Pharmaceuticals are not the only instance where a previously inexpensive generic drug increased in price by more than 400%, said John Bennett, MD, FACC, FACP, president and CEO of CDPHP.

Having a state exchange has allowed even those in the most remote locations of New Mexico to gain assistance with their insurance, said Amy Dowd, CEO of beWellnm.

It is important for consumers to be actively engaged in re-enrolling for health insurance rather than relying on auto-renewal, explained Anne Jessup, senior director of digital channels at Florida Blue.

The financial assistance the Patient Access Network (PAN) Foundation provides patients is an important part of the safety net and happens in a way that doesn't influence how patients get treatment or what products they use, explained Daniel J. Klein, president and CEO of PAN.

Healthcare consolidation must be accompanied with integration of care in order to be successful, explained Robert Nesse, MD, the senior director of Policy and Payment Reform at Mayo Clinic.

When employers only offer high-deductible health plans, they reduce costs by reducing utilization. However, consumers reduce their use of essential as well as nonessential services, which is sub-optimal for their long-term health, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

The newly proposed Medicare Part B payment demonstration met immediate criticism from some in the healthcare industry. Chip Kahn, president and CEO of the Federation of American Hospitals, is also very hesitant about the demonstration and worries that it might be premature.

The idea to let Medicare negotiate drug prices has been kicked around for years, but a number of forces have prevented any legislation from being passed, explained Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future.

Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare, stresses the importance of medical leadership in promoting mHealth and telemedicine in order to get physicians comfortable with these new technologies.

The Institute for Clinical and Economic Review (ICER) created a new drug assessment program with the goal of changing how drugs are priced and evaluated, according to Steven Pearson, MD, MSc, FRCP, founder and president of ICER.

Sister Patricia Codey, SC, Esq., president of the Catholic HealthCare Partnership of New Jersey, discusses legislation in New Jersey that could change the way tiered health plans are created.

Health plans are complex and in order to help members better understand their plans, Blue Cross Blue Shield of Massachusetts is offering more tools from start to finish and obtaining more member input, said Robin Wright King, MBA, director of CDH Product Management at Blue Cross Blue Shield of Massachusetts.

Health technology innovations are transforming the way healthcare is being delivered, but there remain a variety of barriers when it comes to sharing data, said Eric C. Schneider, MD, MSc, senior vice president for policy and research at The Commonwealth Fund.

The value of the ACO & Emerging Healthcare Delivery Coalition live meetings is the information exchange that happens among organizations that are all looking at the same problem but from different angles, said Tabatha Dragonberry.

Starting at the very top, with boards and management is one way that healthcare institutions can better diversify their workforce, and doing so will make health equity achievable, said Georges Benjamin, MD, executive director of the American Public Health Association.

Research advocate Jack Whelan discusses patient involvement in their own care: how to discern which sources are the most reliable, the importance of better incorporating patient-reported outcomes into healthcare, and how patients should become more educated about their care.

There are multiple barriers to accessing innovative oncology care from the design of healthcare benefits to a patient’s position on the federal poverty level, explained Daniel J. Klein, president and CEO of the Patient Access Network (PAN) Foundation.

Payment reform in the US is progressing considerably, but more transparency is necessary in order to change payment for the better in the United States, said Elizabeth Mitchell, president and CEO of the Network for Regional Healthcare Improvement.

When patients select their care delivery sites based solely on price, they may misjudge their options, said Chet Burrell, president and CEO of CareFirst BlueCross BlueShield.

Patients with mental illness can be a very difficult population to treat and programs need to be established that properly meet the health needs of these patients, said Dana Goldman, PhD.

Being transparent is important for pharmacy benefit managers in order to know what the criteria are for coverage, said Glenn D. Stettin, MD.

Robert Nesse, MD, the senior director of Policy and Payment Reform at Mayo Clinic, discussed the impact of healthcare consolidation for consumers, whether or not they are aware of it, and how the government will respond to this consolidation.

Employers can encounter complications with benefit design approaches when it comes to those patients for whom traditional, less-expensive drugs are ineffective, or for those who prefer to have the drugs administered differently, explained Cheryl Larson, BA, vice president of the Midwest Business Group on Health.

How beWellnm, New Mexico's state-based insurance exchange, has defined its role and how it is helping individuals since the implementation of the Affordable Care Act, according to Amy Dowd, CEO of beWellnm.

What New Orleans has done to improve its public health and what "Culture of Health" means to the city, according to Charlotte Parent, director of health of the New Orleans Health Department.

Sarah Lueck, senior policy analyst from the Center on Budget and Policy Priorities, recommends increased transparency of healthcare consolidation, and more research on its impacts, particularly regarding benefits for consumers.