Interviews

In addition to the federal government, state regulators and state insurance commissioners should play a role when considering regulation of recently proposed health insurance mergers, said Sarah Lueck, senior policy analyst from the Center on Budget and Policy Priorities.

In order for consumers to receive the best care for the best cost, it is important for them to be educated about what healthcare services they purchase, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

When pricing new drugs, it’s difficult to understand how their performance will play out in the long term, and for that reason, Institute for Clinical and Economic Review (ICER) has created models that predict future costs and benefits, said Steven Pearson, MD, MSc, FRCP, founder and president of ICER.

Listening to patient-reported outcomes, especially in clinical trials, is extremely important, especially the array of technology available to collect this information, said Sophia K. Smith, PhD, MSW, associate professor at the Duke School of Nursing.

After beWellnm lost a major state insurer, the exchange changed its enrollment strategy and traveled throughout New Mexico to discuss the change in the market and remind the population about the assistance available, explained Amy Dowd, CEO of beWellnm.

Scottsdale Health Partners’ success is derived from its physician engagement, care coordination and transformation, and meaningful IT usage, explained James Whitfill, MD, chief medical officer. The organization has also learned that direct contact with both patients and provider is critical to continuing that success.

CDPHP created the “Inside Look: A Call for Rx Transparency” website in order to educate consumers about drug costs, and motivate people to price drugs in a more rational fashion, said John Bennett, MD, FACC, FACP, president and CEO of CDPHP.

With the recent increase of high-priced drugs, the idea of drug price negotiation in Medicare is receiving more attention as even Part D beneficiaries feel the pinch, said Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future.

Florida Blue has experienced a huge surge in their Hispanic population membership and is working to understand and meet that demographic’s needs, said Anne Jessup, senior director of digital channels at Florida Blue.

One of the greatest challenges for the healthcare industry as it moves to value-based payments is shifting from a short-term to a long-term mode of thinking, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.

Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts, discusses consumer reactions to high-deductible health plans, which ask them to shoulder more of the burden of the cost of their healthcare.

Patients encountering high deductibles regarding medication in their Affordable Care Act plans can seek assistance from drug manufacturers by using copay programs, said Daniel J. Klein, president and CEO of the Patient Access Network Foundation.

Implementing an accountable care organization well without having gone through the process of getting patient-centered medical home designation is a struggle, Jill Watson, MBA, chief executive officer of The Kansas City Metropolitan Physician Association, said at the National Association of ACOs Spring 2016 Conference.

Changes with insurance products have led to more costs being shifted to consumers and they are having very mixed emotions when faced with high-deductible health plans, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

Patient-Centered Diabetes Care (PCDC) is important because it provides a venue to share new knowledge and to meet different stakeholders that impact diabetes care, explained Robert A. Gabbay, MD, PhD, FACP, chief medical officer of the Joslin Diabetes Center, chair of PCDC, and editor-in-chief of Evidence-Based Diabetes Management.

Hurricane Katrina revealed the gaps in public health services in New Orleans, especially for those living in poverty, said Charlotte Parent, director of health of the New Orleans Health Department.

Scottsdale Health Partners has improved coordinated care on both a physical and a virtual level through the creation of a secure texting connection for real-time collaboration, James Whitfill, MD, chief medical officer of Scottsdale Health Partners, explained at the National Association of Accountable Care Organizations’ Spring 2016 Conference.

Florida has not been very good with healthcare cost transparency in the past, but there have been many new programs and tools introduced in order to remedy that, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

The move to value-based payment is going well, but the real work has to be done on the care transformation side, Farzad Mostashari, MD, co-founder and chief executive of Aledade.

How new technologies like mHealth and wearables may affect insurance providers and patient costs, according to Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare.

Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future, discussed patient access to expensive treatments and the barriers to improving transparency.

Many consumers don’t understand high-deductible health plans and how all the components involved operate within that plan, said Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts.

As more attention has been drawn to high-cost drugs, the Institute for Clinical and Economic Review has introduced a focus on drug pricing in its reports, explained Steve Pearson, MD, MSc, FRCP, founder and president of ICER.

Getting patients access to their own data is a good thing that will increase engagement, but it is important that improving access to data will create cohesive care for the patient and not lead to fragmentation, said Julia Adler-Milstein, PhD, assistant professor at the School of Information and the School of Public Health at the University of Michigan.

Insurer consolidation results primarily in higher premiums, and that the advocated benefits of these mergers has yet to be proven, according to Sarah Lueck, senior policy analyst from the Center on Budget and Policy Priorities.

Chip Kahn, president of the Federation of American Hospitals, discusses the future of the Affordable Care Act, and the importance of coordinated care.

Any attempt at public health outreach is unlikely to succeed without involving community leaders, said Charlotte Parent, director of health of the New Orleans Health Department.

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.