Healthcare Reform—The Debate Continues | HBA

Healthcare Reform—The Debate Continues

Chicago HBA members kicked off the 2010 calendar year with an interactive discussion on the impact of Healthcare Reform Legislation.

Chicago HBA members kicked off the 2010 calendar year with an interactive discussion on the impact of Healthcare Reform Legislation. Throughout the evening, 86 attendees remained fully engaged as they gleaned insight from our three expert panelists: Speakers, Juliana Reed, VP Government Affairs, Hospira, Inc. & Suzanne McDonald, VP Managed Markets and Government Affairs, Orexigen Therapeutics, and Moderator, Clair Callan, MD, MBA, CPE, CEO, Callan Consulting.

Pictured left to right: Juliana Reed, Clair Callan, Suzanne McDonald
Pictured left to right: Juliana Reed, Clair Callan, Suzanne McDonald

This event was just one week after Republican Scott Brown was elected Senator of Massachusetts and the day after President Obama de-prioritized Healthcare Reform (below a jobs stimulus program); timing for this topic could not have been better. All three panelists concurred that legislative attention shifted, almost overnight, from a focus on “insurance reform” to a focus on “jobs.” While 80% of the bill was agreed to previously, the budget deficit and the increased cost of Medicare became the focal issues.

Panelists agreed if any legislation on Healthcare Reform were to pass, that it would be in smaller chunks.

Throughout the evening, key topics on which speakers shared their projections included:

  • Biologic/Biosimilar Legislation
  • Patent Litigation
  • Comparative Effectiveness
  • Medical Device Registries
  • Medicare Reimbursement
  • Importation

McDonald provided perspective on the pharmaceutical landscape and made some predictions on what will likely make it through in the final bill:

  • A path for approving follow on biologics (biosimilars)
  • Pharmaceutical patent settlements
  • Need for strong pharmaco-economic data

What McDonald indicated it is unknown whether the elimination of lifetime caps on insurance plans will remain.

Reed provided perspective on the hospital/provider market. The institutional climate is becoming more challenging with Medicare not paying for re-admissions and increased institutional risk due to “bundled payments” where hospitals control the payment flow to caregivers.

Reed commented that this emphasis on controlling costs is at odds with the additional focus on rewarding quality and safety through bonus payments triggered by achievement of quality and safety standards. More work will still be needed from the Centers for Quality Improvement to help define how this will be managed and implemented.

Reed predicted that:

  • We will see consolidation, as smaller hospitals merge and partner with the larger groups
  • Healthcare IT government funding will go to those who are already using it, making it harder for the late adopters to implement
  • Tort reform is not likely to occur

We were told to look to the U.K. as a model for how their comparative effectiveness and device registries have changed care.

As the evening progressed, there was an interesting turn in conversation from legislative reform to market reform.

The government’s plan had focused more on improving access to care through insurance reform, rather than addressing any fundamental changes in improving delivery of high-quality care while controlling costs. With healthcare expenses consuming nearly 17% of the nation’s GDP, a burgeoning national debt, and a potentially insolvent Medicare reimbursement system, what doesn’t come out of Washington may in turn come out of the payer market.

A true testament of thirst for insight into legislative and market reform was demonstrated as attendees lined up for a turn at the microphone, with 15 people posing questions for the panel before time constraints forced a wrap up.

Attendees were encouraged to stay tuned and be prepared to demonstrate comparative effectiveness for their respective organization’s offerings.

Dr. Callan concluded by identifying some “Leadership Lessons” from Healthcare Reform

  1. Always have a back-up plan—don't have an assumption of success
  2. Listen thoughtfully—don't assume you have all the answers
  3. Saying NO is not leadership—be prepared to bring an alternative solution
  4. Don’t overlook the potential for others to strike deals
  5. Learn to work together
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