Today, the Nashville Health Care Council hosted a discussion with CEOs from two of the most influential health care advocacy organizations in Washington, D.C. Matt Eyles, president and CEO, America’s Health Insurance Plans, and Chip Kahn, president and CEO, Federation of American Hospitals, spoke to a crowd of 250 Council members in a conversation moderated by Melinda Buntin, professor and Mike Curb Chair, Department of Health Policy, Vanderbilt University Medical Center.
View event photos on Flickr.
Photo credit: (c) 2019, Donn Jones.
Buntin began the discussion by asking about the recently introduced bill by House Democrats to insure all Americans through Medicare. Both panelists agreed that while the bill is mostly symbolic, the Medicare-for-all conversation and momentum is something that should be taken seriously by the industry.
“The ACA really was a platform to get to coverage for everyone, and we should be focused on fixing what’s broken with that bill, not starting all over,” Eyles said. “Medicare-for-all would fundamentally change the economic landscape of cities like Nashville, and others throughout the country.”
Back in 2018, Kahn formed the Partnership for America’s Health Care Future, of which AHIP is a participant, in hopes of bringing the health care industry together under a unified voice in opposition for Medicare-for-all.
“Once President Trump was elected and Bernie Sanders continued to tout Medicare-for-all, I thought that we in the industry really needed to take the momentum for it seriously,” said Kahn. “We are for having everyone covered, but we already have a structure for how to do this—the ACA. As an industry, we needed to have some counter-messaging around why Medicare-for all is not the way to go.”
Another discussion topic that has recently been a focus on Capitol Hill is the price of drugs. Again, both panelists agreed that the pharmaceutical industry needs to take more responsibility for their role in setting the price of drugs.
“When the pharmaceutical CEOs testified on Capitol Hill yesterday, they said nothing about how they’re going to lower prices,” said Eyles. “Manufacturers completely control the list price of drugs. They decide if they want to go higher than what’s on the market, or if they want to go lower. Blaming PBMs for rebates is really a deflection.”
In addition, the panelists also agreed the move toward value-based care will continue, workforce issues within the industry need to be addressed and the issue “surprise bills” needs attention. However, one major area of disagreement came when the discussion shifted towards consolidation within the industry, particularly hospital consolidation.
“The consolidation on the insurance side is integration happening along the entire continuum of care, or vertical integration,” said Eyles. “This will lead to better outcomes at a lower cost. However, with straight up horizontal consolidation, like what you see on the provider side, it’s more about market power.”
Kahn countered that the consolidation happening on the provider side, particularly with hospitals, is an inevitability of the changing health care landscape.
“I think all the noted economists, insurance CEOs and policymakers who complain about hospital consolidation live in a total fantasy world,” said Kahn. “The traditional hospital model is fundamentally changing. Inpatient revenue is no longer able to support many hospital systems because so much care is no longer being provided on an inpatient basis. If we look at the entire country, it’s unrealistic to think we’re going to have individual units of free-standing hospitals competing with each other. It’s just not sustainable.”
In conclusion, both panelists highlighted the important role that Nashville and its $92 billion health care industry plays when it comes to impacting policy on the federal level.
“Nashville is absolutely a hub of disruption, innovation and change we want to see within the health care system,” said Eyles. “As an industry, Nashville’s health care leaders need to engage with their respective trade associations, as well as their Congressional leaders to help move policy forward.”