Lifelong Learning: Imagining Health Care Differently

In the future, health care may look very different than it does today. Drexel LeBow’s Corporate and Executive Education recently presented an expert panel on what innovations in health care could mean for insurance companies, employers and consumers.

Three panelists offered diverse perspectives on the topic: Sue Schick, CEO of UnitedHealthcare of Pennsylvania and Delaware; Elizabeth Weber, vice president of benefits at Comcast Cable Communications; and Tom Todorow, a Drexel LeBow alumnus who serves as executive vice president for corporate services and CFO of the Children's Hospital of Philadelphia. Mike Howley, Ph.D., associate clinical professor of marketing at Drexel LeBow, moderated the panel.

In his opening remarks, Howley said we are moving to a bottom-up approach to health policy. “This is one of the key implications of the Affordable Healthcare Act. We want to find what works, and then institutionalize it across the healthcare system.”

Schick said when she’s out meeting with customers, they really don’t have specific questions about the details of health care reforms. “What they want to talk about is costs. Business from small to large are focused on ‘What can we do to improve the health and wellness of our employees? And if we do that, will it lead to reduced costs and taking costs out of the system?’”

She said UnitedHealthcare’s key focus is on helping people live better lives. “Our value proposition is if we can give people and business leaders better information, that’s going to empower them to make better decisions. And if you can make better decisions, that going to lead to improvement in the healthcare system and in your own personal health.”

From the employer perspective, Weber, who oversees coverage for 130,000 Comcast employees and their families, said that rising costs is an issue. Comcast pays for 80 percent of its employees’ coverage, and yet 15 percent of employees decline coverage. Under the Affordable Care Act’s individual mandate, the additional number of employees that are going to need to seek coverage is going to add up to much higher costs for Comcast and other employers.

Weber said Comcast is trying to change the conversation about health care with its employees. “We’ve been pursuing a multi-year strategy. We are trying to make employees more aware of their health issues and encourage them to get better. For the past couple of years we have been having them do health-risk assessments and biometric screenings… and we have started paying upfront for tobacco cessation programs.”

Todorow spoke about the possibility of turning our health care system into a system of accountable care. “It’s really foreign to a lot of health care organizations to say, ‘I’m going to take a per-member, per-month payment, and I’m going to figure out what the health care needs are.’ I think it’s in the right direction because it forces providers to get out of the fee-for-service mentality. It’s still very much a fee-for-service business right now, health care on the provider side. In other words, it’s all production. You do a procedure, you have an in-patient stay, you get paid for it. And you continue to get paid for it.”

He added that he doesn’t think it will be a fad. He said a lot of practices are looking into forming partnerships, because in order to be an accountable care organization, they need to be able to assume risk.

Schick agreed that accountable care organizations could reward better outcomes. “One of the big opportunities to modernize health care is to change the way that health insurance companies would work with a provider. How can we change to pay based on outcomes? accountable care organizations are just one way to do that.”

She offered an example of how accountable care organizations might work: “You’d have one doctor who would be managing your total healthcare and really accessible to you most all of the time to make sure you are making the best decisions about your healthcare. They would not be paid based upon how many times they see you, but based on overall health status. Can we change the physician mindset so that they would be happy if they looked out at their parking lot and said, ‘Hey none of my patients are here today, it’s a good day. They’re healthy, and so that means I’m doing my job.’”