Employers across the country should mobilize and use their numbers to leverage lower health care costs, said Brian Klepper, CEO of the National Business Coalition on Health Care.
Klepper spoke Wednesday at the coalition’s Wichita chapter’s 36th annual health care roundtable.
“It is one of the great mysteries of health care that employers – the people who pay more than almost anybody else as a total percentage of U.S. health care costs – have refused to come together in a meaningful way ... to be a counterweight to the health care industry’s influence,” Klepper said.
“Health care is one-fifth of the U.S. economy in dollars. And it’s one-tenth of all of our jobs. And they are literally the most powerful and influential economic sector in society. There is only one group that is larger and more powerful, and that’s everyone else.”
Klepper, a health care analyst and entrepreneur, said that the business community should adopt strategies that would allow them to navigate around existing health care organizations and their interests. He said employers should come together to make purchasing decisions that reward organizations with good clinical and financial practices and punish those who don’t. He also said they should provide more of a united front on health care policy.
“Take back health care policy so it is not always spun in special interests but it’s crafted in the common interest,” he said.
At the root of the U.S. health care cost problem, Klepper said there are four structural flaws:
• Fee for service, which incentivizes physicians to perform more services.
• Little quality, safety and cost data transparency.
• And subjugated primary care providers
Those flaws make patients, employers, primary care physicians and taxpayers the “losers” and those who work in the health care industry the “winners,” he said. There is a projected shortage of primary care physicians, Klepper said, and those physicians are carrying increasing patient loads with less reimbursement than specialists.
Some in the audience were skeptical that employers could make demands of health care providers and insurers to lower costs, especially in Wichita.
“It takes a partnership,” said Troy Leinen, U.S. corporate health risk manager for Bombardier, who attended the event.
“There’s multiple stakeholders and that’s what this whole conference is about. We have to get all stakeholders involved. So when he says things like ‘the health care industry itself, is any industry going to sit there and want to reduce their revenue?’ We all have shareholders we answer to, and we’re no different. But how do we work together to improve the quality of care, the outcomes and therefore reduce costs?” Leinen said.
“This is one aspect or one view of something we can focus on as an employer or a community, but there are so many others. You can’t focus on one thing in a vacuum. That’s where, from our perspective it’s not going to work. You have to have the engagement of all stakeholders to bring to the table, have honest discussions because they all have shareholders.”
The Wichita Business Coalition on Health Care is made up of employers, providers, insurance companies and others to examine health care costs, quality and access.
This is the first roundtable since the Sedgwick County Health Care Roundtable and the Wichita Business Coalition merged in December.
The theme for this year’s roundtable was “Riding the New Wave of Health Care.” Speakers focused on the changes in health care and different ways people can work to improve outcomes and lower costs, said Janet Hamous, executive director of the Wichita Business Coalition on Health Care
Also at the roundtable, a panel of representatives from Blue Cross Blue Shield of Kansas, Aetna and United Health Care discussed payment and care models they are trying.
The insurance representatives said their companies were experimenting with Patient Centered Medical Homes and Accountable Care Organizations.
Patient Centered Medical Homes are a model that emphasize patients having a primary care provider who helps coordinate their care and focuses on quality, and Accountable Care Organizations, which are a product of the Affordable Care Act, aim to find ways to reduce costs while meeting certain quality standards.
Although moves toward these models improve quality outcomes in pilot programs, it’s too early to tell the impact on insurance rates, said M. Myron Leinwetter, medical director of quality improvement for Blue Cross Blue Shield of Kansas.