The AHIP Institute 2009 in June was supposed to be about finding common ground among stakeholders on various issues surrounding healthcare reform.
While acknowledging areas in which stakeholders are in agreement and collaborating, Nancy Nielsen, MD, president of the American Medical Association, dominated a panel during the general session and took aim at the health insurers.
The industry needs to move to a more clinically integrated healthcare delivery system, but “AHIP has not beenhelpful” in this endeavor because of its negotiation tactic of setting prices,” she said. “I’ve told Karen Ignani (president and CEO of AHIP),” she told the audience, and then added, “We have got to be integrated. I’ve just laid out a challenge (to you).”
Thomas Priselac, president and CEO of Cedars-Sinai Health System in Los Angeles, said that healthcare information technology would enable clinical integration. Regional health information organizations (RHIOs) are the lynchpin of information exchange, and money designated for health information exchanges (HIEs) in the HITECH Act is a “laudable act,” he said.
While Priselac said that HIEs require seed funding, which he hoped would come from states, Nielsen told the audience: “Health plans need to step up.”
On the issue of comparative effectiveness research data, both Nielsen and Priselac agreed that having the data is in the best interests of American physicians. What to do with the data is where the AMA is divided, Nielsen said.
She openly addressed the historically adversarial relationship between physicians and health plans.
Acknowledging that physicians are not paid fairly, Nielsen recommended letting the physicians “put their money where their mouth is” and take back what is appropriate for patients and determine care.
Moderator Susan Dentzer, editor-in-chief of Health Affairs, asked where the two panelists stood on the public plan option desired by the Obama administration.
While the public plan has not been fleshed out, Priselac warned that government underfunding would not be productive. “If it erodes employer-based health plans, it would be a problem and a mistake,” he said. Nielsen said that the country doesn’t need a public plan because the private market can produce competitive plans.
Ultimately, Nielsen and Priselac agreed that health insurance coverage for all must be a part of healthcare reform. Priselac added that payment alignment and addressing socio-economic issues on the demand side of healthcare must also be present.
Nielsen called the desire of stakeholders to find common ground on access to quality, affordable, meaningful healthcare “happy talk.” The real difficulty ahead will be in putting that goal into practice, she said.