On February 23, 2017, the Nashville Health Care Council hosted a discussion with CEOs from two of the most influential health care advocacy organizations in Washington. Rick Pollack, president and CEO, American Hospital Association, and Marilyn Tavenner, president and CEO, America’s Health Insurance Plans, spoke to a crowd of 300 Council members in a conversation moderated by Susan Dentzer, president and CEO, The Network for Excellence in Health Innovation.
Photo credit: (c) 2017, Donn Jones.
Dentzer began the discussion addressing the current state of “ACA whiplash,” the uncertainty surrounding the proposed repeal and replacement of Obamacare. Of all the many factors at play, the panelists agreed that the most fundamental challenge facing Republicans is how to implement a repeal without resulting in a decrease in coverage.
“About 85 percent of those on the exchange received an advance payment of the premium tax credit. Right now, we’re waiting for Congress to decide how they want to manage subsidies and income credits. It really is crunch time,” Tavenner said.
The state of Medicaid, which now covers 75 million individuals, and the proposal to transition Medicaid funding to block grants, was a recurring theme throughout the discussion.
“So much of this is yet to be defined. Our concern continues to be making sure patients have coverage. We support giving flexibility to the states, but our fear is that block grants or per capita caps could be a vehicle that further constrains a program that is already severely underfunded,” Pollack said.
When asked about predictions for the next six months, both experts agreed that the state of health care is unpredictable.
“The movement from volume to value will only continue. I don’t see anyone on either side wanting to undo this trend. If you look at Nashville, this is a community that’s embraced population health and delivering health care in a meaningful way. Lowering costs while doing what’s best for patients is a win-win for everyone,” Tavenner said.
Both Pollack and Tavenner identified pharmaceutical pricing as an important issue for the immediate future.
“I think most of the action around pharma pricing will be at the state level in the years ahead. We are not in favor of price controls, but price transparency is a good thing. We are also supportive of value-based pricing for pharmaceuticals and getting generics and biosimilars to market,” Tavenner said.
With the health care industry evolving at such a rapid pace, both AHA and AHIP are adapting to changing business models to meet the needs of their members. Tavenner emphasized that, in addition to responding to regulatory changes coming out of Washington, AHIP is focused on how its members can offer improved health, affordability and financial security to consumers.
“We are redefining the ‘H’ in AHA, because the ‘H’ is more than the building. Care outside of the hospital, whether that is managing chronic conditions, telemedicine, hospitals at home or other care settings, are central to the continuum. Consumerism, convenience and accessibility are all top-of-mind for our members, and we continue to adapt to changes in the provider space,” Pollack said.
The presenting sponsor for today’s program was BlueCross BlueShield of Tennessee. Supporting sponsors were Bass, Berry & Sims, Cressey & Company, KPMG, and LifePoint Health.
About the Nashville Health Care Council
The Nashville Health Care Council is a premier association of health care industry leaders working together to further establish Nashville’s position as the nation’s health care industry capital. Supported by nearly 300 corporate members, the Council serves as a trusted source for information on trends that influence the health care industry. The organization provides members with one-of-a-kind networking opportunities and access to Nashville’s elite health care business community.
Worldwide, Nashville’s health care industry generates more than 500,000 jobs and $73 billion in annual revenue. The industry is Nashville’s largest and fastest-growing employer. For more information on the Council, please visit www.healthcarecouncil.com.