Healthcare Reform Stakeholders Summit, Fall 2015 - Episode 15

The Next Big Frontiers in Healthcare

As the fall Healthcare Reform Stakeholders Summit concludes, the panelists spend some time highlighting the biggest issues that the healthcare industry needs to continue monitoring.

Matt Salo noted that one thing that is mostly absent in the Affordable Care Act’s legislation is something on long-term care, of which Medicaid is by far the largest payer in the country. Currently, long-term care accounts for a sizable portion of Medicaid’s budget and Salo only expects that to grow.

“It’s something that I think we should be very concerned about because, by definition, Medicaid is a low-income program,” Salo said. “And when a low-income program is your only payer of long-term care, if you want long-term care you have to impoverish yourself. And that’s what we require in this country. And I think that’s a terrible, terrible national policy.”

Margaret E. O’Kane, MHA, said that the healthcare industry needs to give up on “market fantasies” and the idea that the market will take care of it. Recent specialty drug prices have disproven that notion.

Leah Binder’s main concerns are keeping the focus on the delivery of excellent care to the patient, which requires transparency and candor. Also, she wants better alignment between employers, who often get overlooked in healthcare policy discussions, and the public sector.

Lastly, Austin Frakt, PhD, is looking forward to better discussion about cost effectiveness. He wants to be able to discuss it without panic about rationing. Currently, people are using the term value instead of cost effectiveness because of the conceptions people might draw.

“I look forward to when we can discuss it a little more openly and be more explicit about, ‘you know what? That’s not valuable,” he said. “That’s what I’m looking at for the next big frontier.”