For the 1st time ever, HIMSS (the annual meeting place for all things health IT) and ACLC (Accountable Care Learning Collaborative) held a joint conference, in Orlando, Florida. Suffice it to say it was a HUGE (no pun intended, Mr. President) event with over 40,000 (yes, 40K) attendees and 1,200+ exhibiting companies.
The main topic—transforming healthcare.
Senator Orrin Hatch (R-UT), Senate Pro-Tempore, US Senate made an appearance, albeit via video. It’s well known that Senator Hatch has played a vital role in shaping healthcare legislation for a very long time. What may not be as well known is that former 3-time elected Utah Governor Mike Leavitt is Senator Hatch’s main go to person for healthcare strategies. Governor Leavitt is an impressive American. He’s described as “an innovator, collaborator, entrepreneur, policy strategist, and seasoned diplomat.”
In addition, he’s a former Cabinet member under President George W. Bush, having been head of the Department of Health and Human Services (DHHS) among other high level appointments. For context purposes, Governor Leavitt is now head of Leavitt Partners (which runs ACLC) and to paraphrase the old E.F. Hutton advertising jingle, “When Governor Leavitt speaks, people listen!”
He began his talk titled “Navigating the Healthcare Horizon” by postulating that healthcare reform is not recent but actually started, at least 25 years ago, with the implementation of DRGs and attempts at managing care through risk based contracts and other such initiatives. He believes we are in a 40 year transformational cycle (as previously stated, we’re 25 years into it) and within the next 15 years, healthcare will be significantly transformed into a more collaborative and accountable delivery system.
So, here are 5 takeaways from Governor Leavitt’s perspective.
First, and probably the most salient point one should ponder, is that the basis for substantially moving from fee-for-service to value payments is NOT being driven by Washington but by global economic forces. By the year 2025, it’s projected that healthcare expenditure in the US will track in at 20% (19.9% to be exact) of our GDP. That, argues Gov Leavitt is a recipe for disaster for the economics of our country. Put succinctly, these projections are not sustainable if the US wishes to retain our title of world leader.
Second, by the end of April 2017, there will be a bill that’ll pass Congress, signed by the President and inclusive of the words, “Repeal & Replace.” To be determined are the definitions of each word. In the end, the process could more appropriately be described as “Adjust & Adapt.”
Third, the list of items to be agreed upon by the Republicans and Democrats will get smaller, not larger. The common denominator will shrink!
Fourth, the transition to the new bill will not happen quickly but will actually take 3-4 years.
Fifth, referring to his assertion that health reform is on a 40 year journey and we’ve been in the game for at least the past 25 years, he compared the next 15 years to a football analogy of entering the red zone, it’s a “readiness issue,” i.e., have you created the right change processes to win big, score touchdowns, not just field goals or worse yet, not score at all.
Gov Leavitt concluded his thoughts by contending there are at least 3 significant underpinnings to galvanize folks into working toward agreement, a) fee-for-service and fragmented care is a problem, b) coordinated care is better than non-coordinated care and c) bend the cost curve.
Finally, he contends that it’s taken most of the successful integrated systems anywhere from 5-9 years to truly turn the corner and believes that ACLC’s efforts at building the tools and bringing together the learnings of these past efforts will shorten the journey considerably, suggesting that 3 years is doable and on the near horizon.
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