Fred Hessler, managing director of the Health Care Group of CitiGroup in New York said, "Humana is getting into the care delivery business as much as anything with some of their acquisitions. Others are staying totally away from of it. It's not clear at all what is ultimately going to happen with the big players."
Nancy Schlicting, president and CEO of Henry Ford Health System in Detroit called this aspect of healthcare "fascinating."
She added that in the Detroit area, dominant Blue Cross has created some pilot programs with medical home models and driven a lot of quality improvement performance. "We've seen some evidence that again, with the right integrated model with payers, that providers and payers can work together for the right ends but it's going to be complicated for awhile."
Chris Van Gorder, President and CEO of Scripps Health noted, "I think the jury is still out," but added that his organization is talking with private insurance companies "to see if there's an opportunity for partnership to use the data and information they have—if there's an opportunity to work together."
If doctors and hospitals "don't find a way to come together and create a better healthcare community, health insurance companies will come in and fill the void, for control reasons. And make a profit," he said. "It's up to us as providers to solve this problem instead of waiting for insurance companies to come in and solve the problem for us."
7. Your ACO is delighted to make your acquaintance
Ian Morrison, futurist, author, and blogger, perhaps got the best laugh of the summit during his keynote when he described a letter Medicare beneficiaries might receive to explain an ACO.
Dear [Name Withheld to be HIPAA Complaint]:
It's now official. While we have seen quite a bit of each other this past year, we just heard from the good folks at Medicare that we are now officially responsible for the quality and costs of the medical care you got this past year. It was as much of a surprise to us as it must be to you. Nevertheless, we are delighted to have you.
However, the relationship has gotten off to a bit of a rocky start. We see from your records that you had a heart attack in Florida when you were visiting cousin Mildred. To make matters worse, they did not give you an aspirin on discharge and now we won't get our bonus.
We really hope you take much better care of yourself in the coming year and don't travel so much.
The Patient Centered Medical Home Team at St. Jude the Obscure ACO
Yes, Morrison got a big laugh. But clearly these are serious times in patient care. In the next few weeks, I hope to write more about some of the exciting and intriguing concepts that were featured here.