State of the State 2012

Health Care Leaders Address Elections, Economy, and “Value Medicine”

Posted in Health Policy, Health Reform, State of the State 2012 on October 18th, 2012 by Erica Noonan – Comments Off on Health Care Leaders Address Elections, Economy, and “Value Medicine”

About 10 years ago, Craig E. Samitt, M.D., the president and CEO of Dean Clinic in Madison, Wisc., made a decision.

Instead of focusing on “heads in beds” like so many health systems, his system would focus on what he now terms as “Value Medicine.”

“Let the rest of the industry focus on volume. We’re focusing on value,” Dr. Samitt recounted on Thursday during his address at the State of the State’s Health Care Forum, hosted by the Massachusetts Medical Society.

The leadership forum, now in its 13th year, also featured remarks by Massachusetts Governor Deval Patrick, Harvard School of Public Health Associate Dean Robert J. Blendon, and economist Robert J. Shapiro, who served as Under Secretary of Commerce for Economic Affairs during the Clinton Administration.

He described the hard-won lessons learned by his physician-owned and governed health system.  Namely,  ACOs must be a team of equals, with hospitals, physicians, and insurers all learning to partner, not compete with each other.

“Everyone has to integrate around value. All health care systems that succeed in the future will focus on teamwork,” Dr. Samitt said.

One of the most important changes was Dean’s investment in primary care. Instead of insisting that Dean PCPs see a huge volume of patients, said Dr. Samitt, “we turned the treadmill off” to instead focus on care coordination.

The system has also looked for ways to serve patients virtually and is making data on its physicians – including metrics on patient satisfaction – unblinded so that Dean’s doctors can see how they compare to their peers.  Soon those metrics will be tied to financial incentives, Dr. Samitt said.

In a set of remarks titled, “The Implications of the 2012 Elections for U.S. Health Reform,” Blendon spoke about a deeply divided national electorate, where health care currently ranks second in voter concerns.  The country is almost evenly split on federal health reform, but 52 percent want some, or all, of the ACA repealed.

Shapiro gave the forum’s final talk, titled “Healthcare and its Impact on the Economy.”

He discussed how rapid increases in health costs have contributed to slowing U.S. job and income growth, compared to European nations and Japan, where government cost controls are in place.  He predicted that if unchecked, U.S. health care costs could consume an estimated 30 percent of the average family’s income.

– Erica Noonan

Gov. Patrick Speaks on State of Massachusetts Health Care at MMS Forum

Posted in Health Policy, Health Reform, State of the State 2012 on October 18th, 2012 by Erica Noonan – Comments Off on Gov. Patrick Speaks on State of Massachusetts Health Care at MMS Forum

Massachusetts Governor Deval Patrick addressed the state’s largest doctor’s advocacy group on Thursday about the status of the health care and payment reform movements and the challenges that still remain.

Currently, the governor said, 98.2 percent of Massachusetts adults and 99.8 percent of children have insurance coverage. Universal health care has most benefited minority, women, and low-income residents.

Mortality rates for testicular cancer in Hispanic men and cervical cancers in low-income women have seen double-digit decreases because of improved screening services and access to care now available under state law.  An estimated 150,000 Massachusetts residents have stopped smoking due to expanded access to smoking-cessation programs, the governor said.

“We started with the belief that health is a public good…and that this is an expression of the kind of Commonwealth we want to live in,” said Gov. Patrick, the lead speaker at the State of the State’s Health Care forum hosted by the Massachusetts Medical Society.

The leadership forum, now in its 13th year, also featured introductions by Mass. Health and Human Services Secretary JudyAnn Bigby, MD, and remarks by Harvard School of Public Health  Associate Dean  Robert J. Blendon,  ScD, Dean Clinic President and CEO Craig Samitt, MD, MBA, and Robert J. Shapiro, PhD, an economist and  former U.S. Under Secretary of Commerce for Economic Affairs.

A separate and ongoing challenge in the state’s health care reform process is insuring that premiums and heath care spending remain under control.  Otherwise, they remain a significant obstacle to economic recovery.  Small business owners need to be certain they can afford to take on new employees.

“Eighty-five percent of businesses in the Commonwealth are small businesses. If they don’t start hiring, we don’t get a recovery,” Gov. Patrick said.

The payment reform legislation signed into law this summer  – which ties health care costs to state economic growth and includes medical malpractice reforms – is the next step towards a system that offers incentives for good care, not “more care,” the governor said.

After his remarks, the governor took questions from the physicians in the audience.  He addressed the state’s growing physician shortage and difficulty in the recruitment and retention of primary care physicians.    A promising debt-forgiveness program  for medical school graduates  that added dozens of new PCPs to the state had to be scuttled during budget cutbacks in recent years, he said.

The governor also urged physicians to become involved in new advisory commissions to help guide payment reform, and advised hospital administrators to continue their work in eliminating systemic cost inefficiencies.

— Erica Noonan

Video: Governor Patrick’s Remarks