SlideShare a Scribd company logo
HEALTH REFORM 2.0:
FROM COVERAGE TO COSTS AND
THE ROLE OF TECHNOLOGY

SARAH ISELIN
Mass Technology Leadership Council
April 24, 2012



                          BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
Massachusetts Now Has the Lowest Rate
of Uninsurance in the Country


PERCENT UNINSURED, 2000–2010, ALL AGES

                                                                                                                                                        16.1%                  16.3%
                                                          14.9%                   15.2%                  14.7%                  14.9%
                                   13.9%
            13.1%

             U.S.
           AVERAGE
                                                           7.4%
                                    6.7%                                           6.4%
             5.9%                                                                                         5.7%

                                                                                                                                  2.6%                   2.7%
                                                                                                                                                                                1.9%

             MASS.

             2000                   2002                   2004                   2006                    2007                   2008                    2009                   2010
NOTE: The Massachusetts-specific   results are from a state-funded survey, the Massachusetts Health Insurance Survey (MHIS), which estimated that 372,000 Massachusetts residents were uninsured in
2006, or 6.4 percent of the state's population. Using a different methodology, researchers at the Urban Institute estimated that 507,000 Massachusetts residents were uninsured in 2005, or
approximately 8.1 percent of the total population. Starting in 2008, the MHIS sampling methodology and survey questionnaire were enhanced. These changes may affect comparability of the 2008
and later results to prior years. The national comparison presented here utilizes a different survey methodology, the Current Population Survey, which is known to undercount Medicaid enrollment in
some states.
SOURCES: Urban Institute,
                       Health Insurance Coverage and the Uninsured in Massachusetts: An Update Based on 2005 Current Population Survey Data In Massachusetts, 2007; Massachusetts Division of
Health Care Finance and Policy, Massachusetts Health Insurance Survey 2000, 2002, 2004, 2006, 2007, 2008, 2009, 2010; U.S. Census Bureau, Current Population Survey 2010.


                                                                                                                                BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 1
But the Highest Per Person Health Care Spending…


PER CAPITA PERSONAL HEALTH CARE EXPENDITURES, 2009
  $10,000


   $9,000


   $8,000


   $7,000
                    NATIONAL AVERAGE
   $6,000


   $5,000


   $4,000


   $3,000


   $2,000


   $1,000


        $0
               UT AZ GA ID NV TX CO AR CA AL VA SC TN NC OK MS OR KY MI MT NM IN IL KS WA LA HI IA MO WY NE SD OH FL WI MNMD NJ VT WV PA ND NH RI NY DE ME CT AK MA

                                                                                                        State


NOTE: District of   Columbia is not included.
SOURCE: Centers for Medicare     & Medicaid Services, Health Expenditures by State of Residence, CMS, 2011.


                                                                                                                BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 2
Though Health Reform Helped, Costs Are Still a Problem
   for Many Massachusetts Residents
                                                                                                        2006             2010




                                                                                                                       20%
                                                             19%                                       19%
                                                                           18%




                            10%



                                                6%




Had Out-of-Pocket Spending at or Above 10% Family Income Problems Paying Medical Bills
                                                      Had                                               Had Medical Debt



   SOURCES: Massachusetts   Health Reform Survey, 2010


                                                                                         BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 3
Overall Spending Will Double Between 2009 and 2020

 ACTUAL AND PROJECTED MASSACHUSETTS TOTAL PERSONAL HEALTH CARE EXPENDITURES, 1991-2020
 (BILLIONS OF DOLLARS)

                     ACTUAL             PROJECTED                                                                                                                                            $123
                                                                                                                                                                                      $116
                                                                                                                                                                               $109
                                                                                                                                                                        $103
                                                                                                                                                                  $97
                                                                                                                                                            $92
                                                                                                                                                      $86
                                                                                                                                                $81
                                                                                                                                         $77
                                                                                                                                   $72
                                                                                                                             $68
                                                                                                                       $61
                                                                                                          $56 $58
                                                                                                    $52
                                                                                              $48
                                                                                       $45
                                                                                 $42
                                                                           $39
                                                                    $36
                                          $33
                                  $30 $31
                          $27 $28
              $23 $24 $25
      $20 $21




      1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

                                                                                               Year
SOURCES: Centers for Medicare& Medicaid Services, Health Expenditures by State of Residence, CMS, 2011; Massachusetts Division of Health Care Finance and Policy, “Massachusetts Health Care Cost
Trends, Historical (1991-2004) and Projected (2004-2020),” November 2009.


                                                                                                                               BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 4
The More We Spend on Health Care, the Less
We Have for Other Things
STATE BUDGET FY 2001 VS. FY 2011 (BILLIONS OF DOLLARS)


                 FY2001                               FY2011
$16
                  +$5.1 B (+59%)                                                                  -$4.0 Billion (-20%)
$14
                                              STATE EMPL.
                                              +40%
$12

$10
                                                                                                   -15%
  $8     STATE EMPL.


  $6                                          MEDICAID/
                                              HCR                                                                         -13%
                                              +61%
                                                                                                                                                      -11%
  $4       MEDICAID/
                HCR
                                                                                                             -23%
                                                                                                                                        -50%
                                                                       -38%             -33%
  $2

  $0
                                Health                             Public           Mental     Education    Infra/     Human          Local        Public
                               Coverage                            Health           Health                 Housing     Services        Aid         Safety


SOURCE: Data extracted   from Massachusetts Budget and Policy Center’s Budget Browser


                                                                                                               BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 5
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 6
Costs Are Now the Most Important
Health Care Issue for the Public


Q   PLEASE TELL ME IF YOU CONSIDER IT TO BE A CRISIS, A MAJOR PROBLEM,
    A MINOR PROBLEM, OR NOT A PROBLEM IN THE STATE OF MASSACHUSETTS.


A     High cost of health care
                                25%                                                                   53%
                                                                                                                      Crisis             Major problem


                                                                                                                                                 78%
      Limited ability to get needed health care
                   14%                                                  32%                         46%
      Low quality of health care services
             11%                                     22%                            33%
      Long wait time for medical appointments
        5%                                  26%                                 31%




SOURCE: Blendon,   R.J. et al., 2011. “Public Perceptions of Health Care Costs in Massachusetts.”


                                                                                                            BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 7
And the Public Is Ready for Major Action
by the State Government


Q   HOW IMPORTANT IS IT FOR THE STATE GOVERNMENT OF MASSACHUSETTS TO
    TAKE SOME MAJOR ACTION TO ADDRESS RISING HEALTH CARE COSTS IN THE STATE?


A     Very Important
                                                                                                                                  74%
                                                                                                                                               88%
      Somewhat Important
                                         14%
      Not Very Important
             3%
      Not At All Important
         1%



      MA State Government should not try to
      address rising costs in state
                       6%
SOURCE: Blendon,   R.J. et al., 2011. “Public Perceptions of Health Care Costs in Massachusetts.”


                                                                                                    BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 8
Key Affordability/Cost-Related
Developments in Massachusetts


     2006              2007               2008              2009            2010                2011                 2012
 Health          Much of              Cost             Special        Government        Governor           Cost
  reform           Chapter 58            Containment       Commission      reports and        Patrick files       Containment
  passes           enacted, e.g.:        Part 1 (Ch.       on Payment      hearings on        payment             Part 3?
  (Ch. 58)        – MassHealth           305) passes       Reform          cost drivers       reform
 – Begins path      expansion           – Increased       – Recommends    Governor           legislation
   to near        – Commonwealth          transparency      move to        rejects small     Special
   universal        Care                  about cost        global         group              Commission
   coverage       – Consumer              drivers           payment        premiums           on Provider
                    affordability       – Reports on                                          Price
                                                                          Cost
                    schedule              health                                              Reform
                                          insurer and
                                                                           Containment
                  – New health                                             Part 2 (Ch.
                    plan options for      hospital
                                          “reserves”                       288) passes
                    young adults
                                                                          – Aims to
                  – Employer Fair
                                                                            control
                    Share
                                                                            premiums
                                                                            for small
                                                                            business,
                                                                            individuals




                                                                                 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
Technological Advances in Care Have Been a Major Driver
of Health Care Spending Growth
CONTRIBUTION TO GROWTH IN SPENDING 1960 – 2007 OECD COUNTRIES                                                                                     Using data from
                                                                                                                                                  developed countries
                                                                                                                                                  around the
                                                                                                                                                  world, economists
                                                                                                          Technology                              estimate that advances in
      Income Effects                                                                                                                              medical technology
                                             29%                                            26%
                                                                                                                                                  explain up to about half
                                                                                                                                                  of the total increases in
                                                                                                                                                  real spending between
                                                                                                                                                  1960 and 2007; this is
                                                                                                                                                  split evenly between
                                     5%                                                                                                           straight technological
   Medical Price                                                                                                                                  advances in care, and the
   Inflation                                                                               27%                                                    fact that as income
                                            7%
                                                                                                                                                  grows, consumers
      Population Aging                                                                                                                            demand proportionally
                                                          11%
                                                                                                     Technology-                                  more high tech care.
                                             Increased                                               Income Interaction
                                             Insurance
                                             Coverage
SOURCE: Smith S, Newhouse   JP, Freeland, MS. “Income, Insurance, and Technology: Why Does Health Spending Outpace Economic Growth? Health Affairs 2009; 28(5): 1276-1284.


                                                                                                                            BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
Much of the Increased Spending on Medical Technology
Has Bought Increased Health Value
                                                                                                                                               Technological advances in
                                                                                                                                               care have dramatically
                                                                                                                                               increased the costs of
                                                                                                                                               medical treatments. In
                                                                                Additional Health                                              one study, economists
                                                                                      Value                                                    found that the cost to
   Net Benefit of                                                                    $70,000
      Additional                                                                                                                               treat a heart attack rose
         Cost of
                  $60,000
                                                                                                                                               $10,000 between 1984
        Treating
                                                                                                                                               and 1998. But the
   Heart Attacks
                                                                                                                                               improvement in care
                                                                                                                                               created $70,000 “worth”
                                                                                                                                               of health over the same
                                                                                                                                               period, measured as the
                                                                                                                                               dollar value of additional
                                                                                                                                               years of life gained by a
                                 Increase in
                               Treatment Cost                                                                                                  patient undergoing the
                                   $10,000                                                                                                     more advanced
                                      Heart Attack Treatment 1984 - 1998                                                                       treatments.
SOURCE:   Cutler, D.M. and M. McClellan, 2001. “Is Technological Change in Medicine Worth It?” Health Affairs, 20 (5): 11-29.


                                                                                                                                BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 11
But Certainly Not All of It




                              BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 12
Health Care Technology – Especially Information
Technology – Can Be a Major Health Care Cost-Saver




                                                                                                                                                                 $80 Billion in
                                                                                                                                                                 potential savings
SOURCE:Hillestad, R et al. 2005. “Can Electronic Medical Record Systems Transform Health Care? Potential Health? Potential Health Benefits, Savings and Costs”
Health Affairs, 24 (5): 1103-1117.


                                                                                                                                 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 13
But Mere Installation of Technological Tools Will Not
Yield Cost Savings Alone




                                           BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 14
Increased HIT Adoption Could Be Cost-Saving or Cost-
Additive in Massachusetts
PROJECTED SAVINGS AS A SHARE OF SPENDING 2010–2020



                                                            Utilize bundled payment              -5.9%                                                  -0.1%

                                           Institute hospital all-payer rate setting                        -4.0%                                       0.0%

                             Institute regulation for academic medical centers                                        -2.7%                             -0.2%

                                 Eliminate payment for adverse hospital events                                                -1.8%            -1.1%

                                                            Increase adoption of HIT                                          -1.8%                            0.6%

                   Institute reference pricing for academic medical centers                                                       -1.3%                 -0.1%

                                       Expand scope of practice for NPs and PAs                                                   -1.3%            -0.6%

                                                   Promote growth of retail clinics                                                    -0.9%            0.0%

                                                               Create medical homes                                                    -0.9%                 0.4%

                                              Decrease resource use at end of life                                                             -0.2%    -0.1%

                                        Encourage value-based insurance design                                                                 -0.2%        0.2%

                                             Increase use of disease management                                                                -0.1%                1.0%


                                                                                           -7%      -6%   -5%   -4%     -3%      -2%      -1%          0%       1%         2%



SOURCE: RAND. “Controlling   Healthcare Spending in Massachusetts: An Analysis of Options.” 2009.


                                                                                                                       BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 15
It’s All About Incentives

  The current payment system, called fee-for-service (FFS), rewards
  doctors and hospitals for doing more.

  This is doubly true for new medical technologies, as newer, high-tech
  services tend to garner higher payments.

  Providers also face few incentives to invest in information technology
  that could help reduce unnecessary use of health care.




                                                   BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 16
Special Commission on the Health Care
Payment System’s Recommendation
     CURRENT FEE-FOR-SERVICE                        PATIENT-CENTERED GLOBAL
        PAYMENT SYSTEM                                   PAYMENT SYSTEM
 THE PROBLEM                                      THE SOLUTION
 Care is fragmented instead of                    Global payments made to a group of
 coordinated. Each provider is paid for           providers for all care. Providers are not
 doing work in isolation, and no one is           rewarded for delivering more care, but
 responsible for coordinating care.               for delivering the right care to meet
 Quality can suffer, costs rise and there is      patient’s needs.
 little accountability for either.
                                                                            $
                                                                        $
     $          $            $           $


                                                                  PRIMARY CARE

                                                                    HOSPITAL

                                                                    SPECIALIST

  HOSPITAL   SPECIALIST   PRIMARY      HOME                       HOME HEALTH
                            CARE       HEALTH

     GOVERNMENT, PAYERS AND PROVIDERS WILL SHARE RESPONSIBILITY FOR PROVIDING
INFRASTRUCTURE, LEGAL AND TECHNICAL SUPPORT TO PROVIDERS IN MAKING THIS TRANSITION.

                                                       BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 17
Information Technology Will Be Key for the Success of
Payment Reform

 Under global payments, providers will face greater incentives to invest
 in innovative technologies that help manage and coordinate care across
 settings.

 Provider groups accepting global payments will need tools and IT to help
 “divide the pie.”

 Insurers and providers will also need innovative ways to engage
 consumers in selecting high-value care.




                                                  BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 18
But How Much We Pay – Prices – Is Just as Important as
the Way We Pay for Care
BCBSMA COST DRIVERS FROM 2004-2008
PERCENT OR INCREASE IN COSTS DUE TO CHANGE IN PRICE VS. PROVIDER/SERVICE MIX VS. UTILIZATION
                        100%

                          90%                                                                UTILIZATION
                                                                                           (number of visits)
                          80%

                          70%
                                                                               PROVIDER MIX AND SERVICE MIX
                          60%
                                                                                                     58.0%
                                                                         53.3%                                                      54.8%                    53.8%
                          50%

                          40%
                                            33.1%
                          30%                                                             UNIT PRICE
                                                                                   (amount providers get paid)
                          20%

                          10%

                            0%

NOTES:
                               2004                              2005                              2006                              2007                              2008
1) Reflects fully-insured commercial trend
2) “Unit price” reflects increases in provider rates. “Provider Mix and Service Mix” reflect changes in the location of care (shift to more expensive providers) and the intensity of services provided.
“Utilization” reflects increases in the number of services provided.
SOURCE: Office of Attorney General Martha Coakley, March 2010, “Investigation of Health Care Cost Trends and Drivers.”



                                                                                                                                      BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 19
The Crux of the Current Political Debate Centers on the
Appropriate Role for Government and the Market




                                           BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 20
Stay Tuned…

 Massachusetts has made health care “universally accessible, but not yet
  universally affordable…Massachusetts led the nation on health care reform
  and is poised to lead again on cost containment.”
                                                    -Governor Deval Patrick

 “…I think more immediately the issues of the health care debate and the
  budget really are going to require our attention”
                                            -House Speaker Robert A. DeLeo

 “A careful, phased-in transition of this system-wide reform [removing fee-
  for-service within 5 years] is achievable. But we need to take the first step
  this year.”
                                            -Senate President Therese Murray



                                                     BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 21

More Related Content

What's hot

Mili slides schoenman
Mili slides schoenmanMili slides schoenman
Mili slides schoenman
nihcm
 
Health care spending slides mili - schoenman
Health care spending slides   mili - schoenmanHealth care spending slides   mili - schoenman
Health care spending slides mili - schoenman
nihcm
 
Nfib ny minimum wage study - 2012
Nfib ny minimum wage study - 2012Nfib ny minimum wage study - 2012
Nfib ny minimum wage study - 2012
Unshackle Upstate
 
Dalkeith
DalkeithDalkeith
Dalkeith
SuburbFlyover
 
Wcf (276) December 30, 2008
Wcf (276) December 30, 2008Wcf (276) December 30, 2008
Wcf (276) December 30, 2008
KeithPromisel
 
2012 Investment Review (Us)
2012 Investment Review (Us)2012 Investment Review (Us)
2012 Investment Review (Us)
andrewyoungkofc
 
2013 California Housing Market Update and San Diego Area
2013 California Housing Market Update and San Diego Area2013 California Housing Market Update and San Diego Area
2013 California Housing Market Update and San Diego Area
RealEstateEducation
 
Jrn Initiate
Jrn InitiateJrn Initiate
Jrn Initiate
ttgoods
 
Southwick Real Estate Market Report January 2013
Southwick Real Estate Market Report January 2013Southwick Real Estate Market Report January 2013
Southwick Real Estate Market Report January 2013
Lesley Lambert
 
progress energy 4/3/08
progress energy 4/3/08progress energy 4/3/08
progress energy 4/3/08
finance25
 
2009-10 Economic Contributions Of Intl Students
2009-10 Economic Contributions Of Intl Students2009-10 Economic Contributions Of Intl Students
2009-10 Economic Contributions Of Intl Students
Marty Bennett
 
Wedding Industry Best Practices Survey Presentation
Wedding Industry Best Practices Survey PresentationWedding Industry Best Practices Survey Presentation
Wedding Industry Best Practices Survey Presentation
Wendy Dahl
 
Action Costs Less: The Health Care Amendment, Standards and Options for Reform
Action Costs Less: The Health Care Amendment, Standards and Options for ReformAction Costs Less: The Health Care Amendment, Standards and Options for Reform
Action Costs Less: The Health Care Amendment, Standards and Options for Reform
masscare
 
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
Ryan Slack
 
Southwick, MA Market Report
Southwick, MA Market ReportSouthwick, MA Market Report
Southwick, MA Market Report
Lesley Lambert
 
Mohr and White - Minimizing unemployment costs
Mohr and White - Minimizing unemployment costs Mohr and White - Minimizing unemployment costs
Mohr and White - Minimizing unemployment costs
HR Florida State Council, Inc.
 
Why you should Invest in Chile?
Why you should Invest in Chile?Why you should Invest in Chile?
Why you should Invest in Chile?
Sebastian Landgren
 
NLPU11
NLPU11NLPU11
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
Junho Choi
 
VC Opportunities In Health Care Technology
VC Opportunities In Health Care TechnologyVC Opportunities In Health Care Technology
VC Opportunities In Health Care Technology
vjm8
 

What's hot (20)

Mili slides schoenman
Mili slides schoenmanMili slides schoenman
Mili slides schoenman
 
Health care spending slides mili - schoenman
Health care spending slides   mili - schoenmanHealth care spending slides   mili - schoenman
Health care spending slides mili - schoenman
 
Nfib ny minimum wage study - 2012
Nfib ny minimum wage study - 2012Nfib ny minimum wage study - 2012
Nfib ny minimum wage study - 2012
 
Dalkeith
DalkeithDalkeith
Dalkeith
 
Wcf (276) December 30, 2008
Wcf (276) December 30, 2008Wcf (276) December 30, 2008
Wcf (276) December 30, 2008
 
2012 Investment Review (Us)
2012 Investment Review (Us)2012 Investment Review (Us)
2012 Investment Review (Us)
 
2013 California Housing Market Update and San Diego Area
2013 California Housing Market Update and San Diego Area2013 California Housing Market Update and San Diego Area
2013 California Housing Market Update and San Diego Area
 
Jrn Initiate
Jrn InitiateJrn Initiate
Jrn Initiate
 
Southwick Real Estate Market Report January 2013
Southwick Real Estate Market Report January 2013Southwick Real Estate Market Report January 2013
Southwick Real Estate Market Report January 2013
 
progress energy 4/3/08
progress energy 4/3/08progress energy 4/3/08
progress energy 4/3/08
 
2009-10 Economic Contributions Of Intl Students
2009-10 Economic Contributions Of Intl Students2009-10 Economic Contributions Of Intl Students
2009-10 Economic Contributions Of Intl Students
 
Wedding Industry Best Practices Survey Presentation
Wedding Industry Best Practices Survey PresentationWedding Industry Best Practices Survey Presentation
Wedding Industry Best Practices Survey Presentation
 
Action Costs Less: The Health Care Amendment, Standards and Options for Reform
Action Costs Less: The Health Care Amendment, Standards and Options for ReformAction Costs Less: The Health Care Amendment, Standards and Options for Reform
Action Costs Less: The Health Care Amendment, Standards and Options for Reform
 
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
Spencer Levy - Capital Markets 2.0 - Did We Speak Too Soon?
 
Southwick, MA Market Report
Southwick, MA Market ReportSouthwick, MA Market Report
Southwick, MA Market Report
 
Mohr and White - Minimizing unemployment costs
Mohr and White - Minimizing unemployment costs Mohr and White - Minimizing unemployment costs
Mohr and White - Minimizing unemployment costs
 
Why you should Invest in Chile?
Why you should Invest in Chile?Why you should Invest in Chile?
Why you should Invest in Chile?
 
NLPU11
NLPU11NLPU11
NLPU11
 
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
CDN 기술 동향과 전망 (CDN Technology Trends) - HSN 2013
 
VC Opportunities In Health Care Technology
VC Opportunities In Health Care TechnologyVC Opportunities In Health Care Technology
VC Opportunities In Health Care Technology
 

Similar to 120424 MassTLC Sarah Iselin, BCBSMA Foundation presentation

Presentation: Health Reform in Massachusetts
Presentation: Health Reform in MassachusettsPresentation: Health Reform in Massachusetts
Presentation: Health Reform in Massachusetts
masscare
 
IHC -- Health reform: What it means and what's next
IHC -- Health reform: What it means and what's nextIHC -- Health reform: What it means and what's next
IHC -- Health reform: What it means and what's next
Galen Institute
 
Personalized Healthcare and Research
Personalized Healthcare and ResearchPersonalized Healthcare and Research
Personalized Healthcare and Research
Ryan Squire
 
Dave Entwistle
Dave EntwistleDave Entwistle
Dave Entwistle
Matthew Hewlett
 
Bonfire Health Corporate Wellness Seminars
Bonfire Health Corporate Wellness SeminarsBonfire Health Corporate Wellness Seminars
Bonfire Health Corporate Wellness Seminars
drstephenf
 
Healthcare Reform Charts
Healthcare Reform ChartsHealthcare Reform Charts
Healthcare Reform Charts
stevepagliuca
 
Tobacco Cessation and Worksite Wellness
Tobacco Cessation and Worksite WellnessTobacco Cessation and Worksite Wellness
Tobacco Cessation and Worksite Wellness
Worksite Wellness Council of Massachusetts
 
Ounce Of Prevention T Gouveia 10 4 11
Ounce Of Prevention T Gouveia 10 4 11Ounce Of Prevention T Gouveia 10 4 11
Ounce Of Prevention T Gouveia 10 4 11
tamigouveia
 
ACSG Presentation
ACSG PresentationACSG Presentation
ACSG Presentation
jackell
 
The Economics of Health Reform: Implications for Health Professionals
The Economics of Health Reform: Implications for Health ProfessionalsThe Economics of Health Reform: Implications for Health Professionals
The Economics of Health Reform: Implications for Health Professionals
Sage Growth Partners
 
Medicaid Spending
Medicaid SpendingMedicaid Spending
Medicaid Spending
Unshackle Upstate
 
Summary Presidents Proposal
Summary Presidents ProposalSummary Presidents Proposal
Summary Presidents Proposal
DocJess
 
2010-03-24-Health Reform Update, Capitol Club
2010-03-24-Health Reform Update, Capitol Club2010-03-24-Health Reform Update, Capitol Club
2010-03-24-Health Reform Update, Capitol Club
Salt Lake Chamber
 
Boston University Medical Center
Boston University Medical CenterBoston University Medical Center
Boston University Medical Center
the Health Advocate
 
Medicaid Fraud
Medicaid FraudMedicaid Fraud
Medicaid Fraud
Jess Jacobs
 
Edes va hbpc
Edes va hbpcEdes va hbpc
"U.S. Healthcare Reform"
"U.S. Healthcare Reform""U.S. Healthcare Reform"
"U.S. Healthcare Reform"
UWGlobalHealth
 
Next Practices and Best Places to Work with Dee Edington
Next Practices and Best Places to Work with Dee EdingtonNext Practices and Best Places to Work with Dee Edington
Next Practices and Best Places to Work with Dee Edington
HPCareer.Net / State of Wellness Inc.
 
Opportunities Challenges for Food Beverage and CPG
Opportunities Challenges for Food Beverage and CPGOpportunities Challenges for Food Beverage and CPG
Opportunities Challenges for Food Beverage and CPG
ARC Advisory Group
 
Opportunities and Challenges for the Food Beverage & CPG Industries
Opportunities and Challenges for the Food Beverage & CPG IndustriesOpportunities and Challenges for the Food Beverage & CPG Industries
Opportunities and Challenges for the Food Beverage & CPG Industries
ARC Advisory Group
 

Similar to 120424 MassTLC Sarah Iselin, BCBSMA Foundation presentation (20)

Presentation: Health Reform in Massachusetts
Presentation: Health Reform in MassachusettsPresentation: Health Reform in Massachusetts
Presentation: Health Reform in Massachusetts
 
IHC -- Health reform: What it means and what's next
IHC -- Health reform: What it means and what's nextIHC -- Health reform: What it means and what's next
IHC -- Health reform: What it means and what's next
 
Personalized Healthcare and Research
Personalized Healthcare and ResearchPersonalized Healthcare and Research
Personalized Healthcare and Research
 
Dave Entwistle
Dave EntwistleDave Entwistle
Dave Entwistle
 
Bonfire Health Corporate Wellness Seminars
Bonfire Health Corporate Wellness SeminarsBonfire Health Corporate Wellness Seminars
Bonfire Health Corporate Wellness Seminars
 
Healthcare Reform Charts
Healthcare Reform ChartsHealthcare Reform Charts
Healthcare Reform Charts
 
Tobacco Cessation and Worksite Wellness
Tobacco Cessation and Worksite WellnessTobacco Cessation and Worksite Wellness
Tobacco Cessation and Worksite Wellness
 
Ounce Of Prevention T Gouveia 10 4 11
Ounce Of Prevention T Gouveia 10 4 11Ounce Of Prevention T Gouveia 10 4 11
Ounce Of Prevention T Gouveia 10 4 11
 
ACSG Presentation
ACSG PresentationACSG Presentation
ACSG Presentation
 
The Economics of Health Reform: Implications for Health Professionals
The Economics of Health Reform: Implications for Health ProfessionalsThe Economics of Health Reform: Implications for Health Professionals
The Economics of Health Reform: Implications for Health Professionals
 
Medicaid Spending
Medicaid SpendingMedicaid Spending
Medicaid Spending
 
Summary Presidents Proposal
Summary Presidents ProposalSummary Presidents Proposal
Summary Presidents Proposal
 
2010-03-24-Health Reform Update, Capitol Club
2010-03-24-Health Reform Update, Capitol Club2010-03-24-Health Reform Update, Capitol Club
2010-03-24-Health Reform Update, Capitol Club
 
Boston University Medical Center
Boston University Medical CenterBoston University Medical Center
Boston University Medical Center
 
Medicaid Fraud
Medicaid FraudMedicaid Fraud
Medicaid Fraud
 
Edes va hbpc
Edes va hbpcEdes va hbpc
Edes va hbpc
 
"U.S. Healthcare Reform"
"U.S. Healthcare Reform""U.S. Healthcare Reform"
"U.S. Healthcare Reform"
 
Next Practices and Best Places to Work with Dee Edington
Next Practices and Best Places to Work with Dee EdingtonNext Practices and Best Places to Work with Dee Edington
Next Practices and Best Places to Work with Dee Edington
 
Opportunities Challenges for Food Beverage and CPG
Opportunities Challenges for Food Beverage and CPGOpportunities Challenges for Food Beverage and CPG
Opportunities Challenges for Food Beverage and CPG
 
Opportunities and Challenges for the Food Beverage & CPG Industries
Opportunities and Challenges for the Food Beverage & CPG IndustriesOpportunities and Challenges for the Food Beverage & CPG Industries
Opportunities and Challenges for the Food Beverage & CPG Industries
 

More from MassTLC

MassIntelligence 2018: Intelligent Connected Cities
MassIntelligence 2018: Intelligent Connected CitiesMassIntelligence 2018: Intelligent Connected Cities
MassIntelligence 2018: Intelligent Connected Cities
MassTLC
 
MassIntelligence 2018: How to Rapidly Prototype an AI Solution
MassIntelligence 2018: How to Rapidly Prototype an AI SolutionMassIntelligence 2018: How to Rapidly Prototype an AI Solution
MassIntelligence 2018: How to Rapidly Prototype an AI Solution
MassTLC
 
MassIntelligence 2018: Connecting the Nation's Top Fishing Port
MassIntelligence 2018: Connecting the Nation's Top Fishing PortMassIntelligence 2018: Connecting the Nation's Top Fishing Port
MassIntelligence 2018: Connecting the Nation's Top Fishing Port
MassTLC
 
MassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
MassIntelligence 2018: Transportation & Mobility, Alex WyglinskiMassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
MassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
MassTLC
 
Andres Corrada-Emmanuel - Ground Truth Problems in Business
Andres Corrada-Emmanuel - Ground Truth Problems in BusinessAndres Corrada-Emmanuel - Ground Truth Problems in Business
Andres Corrada-Emmanuel - Ground Truth Problems in Business
MassTLC
 
MassTLC product launch campaign strategies, Jason Baudreau, NetBrain
MassTLC product launch campaign strategies, Jason Baudreau, NetBrainMassTLC product launch campaign strategies, Jason Baudreau, NetBrain
MassTLC product launch campaign strategies, Jason Baudreau, NetBrain
MassTLC
 
MassTLC product launch campaign strategies, ben austin, Carbon Black
MassTLC product launch campaign strategies, ben austin, Carbon BlackMassTLC product launch campaign strategies, ben austin, Carbon Black
MassTLC product launch campaign strategies, ben austin, Carbon Black
MassTLC
 
Forget about A.G.I. Let's Build Useable Ai Tools!
Forget about A.G.I. Let's Build Useable Ai Tools!Forget about A.G.I. Let's Build Useable Ai Tools!
Forget about A.G.I. Let's Build Useable Ai Tools!
MassTLC
 
Cloud Edge Computing: Beyond the Data Center
Cloud Edge Computing: Beyond the Data CenterCloud Edge Computing: Beyond the Data Center
Cloud Edge Computing: Beyond the Data Center
MassTLC
 
Old Company - New Technology, Elixir @ the MBTA
Old Company - New Technology, Elixir @ the MBTAOld Company - New Technology, Elixir @ the MBTA
Old Company - New Technology, Elixir @ the MBTA
MassTLC
 
Lisa seacat deluca io t robotics presentation
Lisa seacat deluca io t robotics presentationLisa seacat deluca io t robotics presentation
Lisa seacat deluca io t robotics presentation
MassTLC
 
Smart cities thinking outside the box
Smart cities thinking outside the boxSmart cities thinking outside the box
Smart cities thinking outside the box
MassTLC
 
Lily lim data privacy ownership and ethics
Lily lim data privacy ownership and ethicsLily lim data privacy ownership and ethics
Lily lim data privacy ownership and ethics
MassTLC
 
Abbas bagasra smart ag
Abbas bagasra smart agAbbas bagasra smart ag
Abbas bagasra smart ag
MassTLC
 
Ben goodman cybersecurity in the iiot
Ben goodman cybersecurity in the iiotBen goodman cybersecurity in the iiot
Ben goodman cybersecurity in the iiot
MassTLC
 
MassTLC Opening Slides and Simulation Session
MassTLC Opening Slides and Simulation SessionMassTLC Opening Slides and Simulation Session
MassTLC Opening Slides and Simulation Session
MassTLC
 
Tom Hopcroft: State of the Tech Economy Key Findings
Tom Hopcroft: State of the Tech Economy Key FindingsTom Hopcroft: State of the Tech Economy Key Findings
Tom Hopcroft: State of the Tech Economy Key Findings
MassTLC
 
Michael Goodman: The State of the State Economy
Michael Goodman: The State of the State EconomyMichael Goodman: The State of the State Economy
Michael Goodman: The State of the State Economy
MassTLC
 
MassTLC summit_amacleod_predictiveanalytics
MassTLC summit_amacleod_predictiveanalyticsMassTLC summit_amacleod_predictiveanalytics
MassTLC summit_amacleod_predictiveanalytics
MassTLC
 
Brainshark mass tlc brand revitalizaion_final for distribution
Brainshark mass tlc brand revitalizaion_final for distributionBrainshark mass tlc brand revitalizaion_final for distribution
Brainshark mass tlc brand revitalizaion_final for distribution
MassTLC
 

More from MassTLC (20)

MassIntelligence 2018: Intelligent Connected Cities
MassIntelligence 2018: Intelligent Connected CitiesMassIntelligence 2018: Intelligent Connected Cities
MassIntelligence 2018: Intelligent Connected Cities
 
MassIntelligence 2018: How to Rapidly Prototype an AI Solution
MassIntelligence 2018: How to Rapidly Prototype an AI SolutionMassIntelligence 2018: How to Rapidly Prototype an AI Solution
MassIntelligence 2018: How to Rapidly Prototype an AI Solution
 
MassIntelligence 2018: Connecting the Nation's Top Fishing Port
MassIntelligence 2018: Connecting the Nation's Top Fishing PortMassIntelligence 2018: Connecting the Nation's Top Fishing Port
MassIntelligence 2018: Connecting the Nation's Top Fishing Port
 
MassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
MassIntelligence 2018: Transportation & Mobility, Alex WyglinskiMassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
MassIntelligence 2018: Transportation & Mobility, Alex Wyglinski
 
Andres Corrada-Emmanuel - Ground Truth Problems in Business
Andres Corrada-Emmanuel - Ground Truth Problems in BusinessAndres Corrada-Emmanuel - Ground Truth Problems in Business
Andres Corrada-Emmanuel - Ground Truth Problems in Business
 
MassTLC product launch campaign strategies, Jason Baudreau, NetBrain
MassTLC product launch campaign strategies, Jason Baudreau, NetBrainMassTLC product launch campaign strategies, Jason Baudreau, NetBrain
MassTLC product launch campaign strategies, Jason Baudreau, NetBrain
 
MassTLC product launch campaign strategies, ben austin, Carbon Black
MassTLC product launch campaign strategies, ben austin, Carbon BlackMassTLC product launch campaign strategies, ben austin, Carbon Black
MassTLC product launch campaign strategies, ben austin, Carbon Black
 
Forget about A.G.I. Let's Build Useable Ai Tools!
Forget about A.G.I. Let's Build Useable Ai Tools!Forget about A.G.I. Let's Build Useable Ai Tools!
Forget about A.G.I. Let's Build Useable Ai Tools!
 
Cloud Edge Computing: Beyond the Data Center
Cloud Edge Computing: Beyond the Data CenterCloud Edge Computing: Beyond the Data Center
Cloud Edge Computing: Beyond the Data Center
 
Old Company - New Technology, Elixir @ the MBTA
Old Company - New Technology, Elixir @ the MBTAOld Company - New Technology, Elixir @ the MBTA
Old Company - New Technology, Elixir @ the MBTA
 
Lisa seacat deluca io t robotics presentation
Lisa seacat deluca io t robotics presentationLisa seacat deluca io t robotics presentation
Lisa seacat deluca io t robotics presentation
 
Smart cities thinking outside the box
Smart cities thinking outside the boxSmart cities thinking outside the box
Smart cities thinking outside the box
 
Lily lim data privacy ownership and ethics
Lily lim data privacy ownership and ethicsLily lim data privacy ownership and ethics
Lily lim data privacy ownership and ethics
 
Abbas bagasra smart ag
Abbas bagasra smart agAbbas bagasra smart ag
Abbas bagasra smart ag
 
Ben goodman cybersecurity in the iiot
Ben goodman cybersecurity in the iiotBen goodman cybersecurity in the iiot
Ben goodman cybersecurity in the iiot
 
MassTLC Opening Slides and Simulation Session
MassTLC Opening Slides and Simulation SessionMassTLC Opening Slides and Simulation Session
MassTLC Opening Slides and Simulation Session
 
Tom Hopcroft: State of the Tech Economy Key Findings
Tom Hopcroft: State of the Tech Economy Key FindingsTom Hopcroft: State of the Tech Economy Key Findings
Tom Hopcroft: State of the Tech Economy Key Findings
 
Michael Goodman: The State of the State Economy
Michael Goodman: The State of the State EconomyMichael Goodman: The State of the State Economy
Michael Goodman: The State of the State Economy
 
MassTLC summit_amacleod_predictiveanalytics
MassTLC summit_amacleod_predictiveanalyticsMassTLC summit_amacleod_predictiveanalytics
MassTLC summit_amacleod_predictiveanalytics
 
Brainshark mass tlc brand revitalizaion_final for distribution
Brainshark mass tlc brand revitalizaion_final for distributionBrainshark mass tlc brand revitalizaion_final for distribution
Brainshark mass tlc brand revitalizaion_final for distribution
 

Recently uploaded

Introduction to Radiotherapy technology I.pptx
Introduction to Radiotherapy technology I.pptxIntroduction to Radiotherapy technology I.pptx
Introduction to Radiotherapy technology I.pptx
JalalEltabib1
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
souravpaul769171
 
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptxPULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
neeti70
 
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxWhy Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
AmandaChou9
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Dr. Jagroop Singh
 
SA Gastro Cure(pancreatic cancer treatment in india).pptx
SA Gastro Cure(pancreatic cancer treatment in india).pptxSA Gastro Cure(pancreatic cancer treatment in india).pptx
SA Gastro Cure(pancreatic cancer treatment in india).pptx
VinothKumar70905
 
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx  Keynotes by H.C. AllenAGARICUS MUSCARIUS.pptx  Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
DR.P.S SUDHAKAR
 
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxExploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
FFragrant
 
lessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical educationlessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical education
DrJALAGAMTHIRUPATHIR
 
Perforation.pptx
Perforation.pptxPerforation.pptx
Perforation.pptx
Nandish Sannaiah
 
Top 10 Habits for Longevity [Biohacker Summit 2024]
Top 10 Habits for Longevity [Biohacker Summit 2024]Top 10 Habits for Longevity [Biohacker Summit 2024]
Top 10 Habits for Longevity [Biohacker Summit 2024]
Olli Sovijärvi
 
Drug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptxDrug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptx
drebrahiim
 
APPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
APPROACH TO DIAGNOSIS OF LIVER DISEASES.pptAPPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
APPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
KarthikeyanA87
 
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptxOperation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
RadhaThapaChhetry
 
Veterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in IndiaVeterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in India
Heilsaa Care
 
Comfort, Rest, Sleep and Pain.pptx
Comfort, Rest, Sleep  and Pain.pptxComfort, Rest, Sleep  and Pain.pptx
Comfort, Rest, Sleep and Pain.pptx
Nandish Sannaiah
 
FUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
FUNCTIONAL DYSPEPSIA by Dr. Maryam IqbalFUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
FUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
Zain Umar
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
MatsikoAlex
 
Journal club presentation JC 28.5.24 edit.pptx
Journal club presentation JC 28.5.24 edit.pptxJournal club presentation JC 28.5.24 edit.pptx
Journal club presentation JC 28.5.24 edit.pptx
AdhyaDubey1
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
Joebest8
 

Recently uploaded (20)

Introduction to Radiotherapy technology I.pptx
Introduction to Radiotherapy technology I.pptxIntroduction to Radiotherapy technology I.pptx
Introduction to Radiotherapy technology I.pptx
 
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptxPOTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
POTENTIAL TARGET DISEASES FOR GENE THERAPY SOURAV.pptx
 
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptxPULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
PULMONARY EMBOLISM AND ITS MANAGEMENT.pptx
 
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptxWhy Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
Why Does Seminal Vesiculitis Causes Jelly-like Sperm.pptx
 
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptxCare and Maintenance of Laboratory Equipment in Histotechnology.pptx
Care and Maintenance of Laboratory Equipment in Histotechnology.pptx
 
SA Gastro Cure(pancreatic cancer treatment in india).pptx
SA Gastro Cure(pancreatic cancer treatment in india).pptxSA Gastro Cure(pancreatic cancer treatment in india).pptx
SA Gastro Cure(pancreatic cancer treatment in india).pptx
 
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx  Keynotes by H.C. AllenAGARICUS MUSCARIUS.pptx  Keynotes by H.C. Allen
AGARICUS MUSCARIUS.pptx Keynotes by H.C. Allen
 
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptxExploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
Exploring Alternatives- Why Laparoscopy Isn't Always Best for Hydrosalpinx.pptx
 
lessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical educationlessonplan JTR.pptx For medical education
lessonplan JTR.pptx For medical education
 
Perforation.pptx
Perforation.pptxPerforation.pptx
Perforation.pptx
 
Top 10 Habits for Longevity [Biohacker Summit 2024]
Top 10 Habits for Longevity [Biohacker Summit 2024]Top 10 Habits for Longevity [Biohacker Summit 2024]
Top 10 Habits for Longevity [Biohacker Summit 2024]
 
Drug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptxDrug Repurposing for Parasitic Diseases.pptx
Drug Repurposing for Parasitic Diseases.pptx
 
APPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
APPROACH TO DIAGNOSIS OF LIVER DISEASES.pptAPPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
APPROACH TO DIAGNOSIS OF LIVER DISEASES.ppt
 
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptxOperation Theatre Nursing -History of Surgery & Anesthesia.pptx
Operation Theatre Nursing -History of Surgery & Anesthesia.pptx
 
Veterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in IndiaVeterinary Medicines Manufacturers in India
Veterinary Medicines Manufacturers in India
 
Comfort, Rest, Sleep and Pain.pptx
Comfort, Rest, Sleep  and Pain.pptxComfort, Rest, Sleep  and Pain.pptx
Comfort, Rest, Sleep and Pain.pptx
 
FUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
FUNCTIONAL DYSPEPSIA by Dr. Maryam IqbalFUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
FUNCTIONAL DYSPEPSIA by Dr. Maryam Iqbal
 
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdfNUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
NUTRICONNECT NEWSLETTER 3RD ISSUE 2ND VOLUME.pdf
 
Journal club presentation JC 28.5.24 edit.pptx
Journal club presentation JC 28.5.24 edit.pptxJournal club presentation JC 28.5.24 edit.pptx
Journal club presentation JC 28.5.24 edit.pptx
 
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptxselllllllllllllllllllllllllllllllllllllllllllllll.pptx
selllllllllllllllllllllllllllllllllllllllllllllll.pptx
 

120424 MassTLC Sarah Iselin, BCBSMA Foundation presentation

  • 1. HEALTH REFORM 2.0: FROM COVERAGE TO COSTS AND THE ROLE OF TECHNOLOGY SARAH ISELIN Mass Technology Leadership Council April 24, 2012 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
  • 2. Massachusetts Now Has the Lowest Rate of Uninsurance in the Country PERCENT UNINSURED, 2000–2010, ALL AGES 16.1% 16.3% 14.9% 15.2% 14.7% 14.9% 13.9% 13.1% U.S. AVERAGE 7.4% 6.7% 6.4% 5.9% 5.7% 2.6% 2.7% 1.9% MASS. 2000 2002 2004 2006 2007 2008 2009 2010 NOTE: The Massachusetts-specific results are from a state-funded survey, the Massachusetts Health Insurance Survey (MHIS), which estimated that 372,000 Massachusetts residents were uninsured in 2006, or 6.4 percent of the state's population. Using a different methodology, researchers at the Urban Institute estimated that 507,000 Massachusetts residents were uninsured in 2005, or approximately 8.1 percent of the total population. Starting in 2008, the MHIS sampling methodology and survey questionnaire were enhanced. These changes may affect comparability of the 2008 and later results to prior years. The national comparison presented here utilizes a different survey methodology, the Current Population Survey, which is known to undercount Medicaid enrollment in some states. SOURCES: Urban Institute, Health Insurance Coverage and the Uninsured in Massachusetts: An Update Based on 2005 Current Population Survey Data In Massachusetts, 2007; Massachusetts Division of Health Care Finance and Policy, Massachusetts Health Insurance Survey 2000, 2002, 2004, 2006, 2007, 2008, 2009, 2010; U.S. Census Bureau, Current Population Survey 2010. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 1
  • 3. But the Highest Per Person Health Care Spending… PER CAPITA PERSONAL HEALTH CARE EXPENDITURES, 2009 $10,000 $9,000 $8,000 $7,000 NATIONAL AVERAGE $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 UT AZ GA ID NV TX CO AR CA AL VA SC TN NC OK MS OR KY MI MT NM IN IL KS WA LA HI IA MO WY NE SD OH FL WI MNMD NJ VT WV PA ND NH RI NY DE ME CT AK MA State NOTE: District of Columbia is not included. SOURCE: Centers for Medicare & Medicaid Services, Health Expenditures by State of Residence, CMS, 2011. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 2
  • 4. Though Health Reform Helped, Costs Are Still a Problem for Many Massachusetts Residents 2006 2010 20% 19% 19% 18% 10% 6% Had Out-of-Pocket Spending at or Above 10% Family Income Problems Paying Medical Bills Had Had Medical Debt SOURCES: Massachusetts Health Reform Survey, 2010 BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 3
  • 5. Overall Spending Will Double Between 2009 and 2020 ACTUAL AND PROJECTED MASSACHUSETTS TOTAL PERSONAL HEALTH CARE EXPENDITURES, 1991-2020 (BILLIONS OF DOLLARS) ACTUAL PROJECTED $123 $116 $109 $103 $97 $92 $86 $81 $77 $72 $68 $61 $56 $58 $52 $48 $45 $42 $39 $36 $33 $30 $31 $27 $28 $23 $24 $25 $20 $21 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Year SOURCES: Centers for Medicare& Medicaid Services, Health Expenditures by State of Residence, CMS, 2011; Massachusetts Division of Health Care Finance and Policy, “Massachusetts Health Care Cost Trends, Historical (1991-2004) and Projected (2004-2020),” November 2009. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 4
  • 6. The More We Spend on Health Care, the Less We Have for Other Things STATE BUDGET FY 2001 VS. FY 2011 (BILLIONS OF DOLLARS) FY2001 FY2011 $16 +$5.1 B (+59%) -$4.0 Billion (-20%) $14 STATE EMPL. +40% $12 $10 -15% $8 STATE EMPL. $6 MEDICAID/ HCR -13% +61% -11% $4 MEDICAID/ HCR -23% -50% -38% -33% $2 $0 Health Public Mental Education Infra/ Human Local Public Coverage Health Health Housing Services Aid Safety SOURCE: Data extracted from Massachusetts Budget and Policy Center’s Budget Browser BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 5
  • 7. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 6
  • 8. Costs Are Now the Most Important Health Care Issue for the Public Q PLEASE TELL ME IF YOU CONSIDER IT TO BE A CRISIS, A MAJOR PROBLEM, A MINOR PROBLEM, OR NOT A PROBLEM IN THE STATE OF MASSACHUSETTS. A High cost of health care 25% 53% Crisis Major problem 78% Limited ability to get needed health care 14% 32% 46% Low quality of health care services 11% 22% 33% Long wait time for medical appointments 5% 26% 31% SOURCE: Blendon, R.J. et al., 2011. “Public Perceptions of Health Care Costs in Massachusetts.” BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 7
  • 9. And the Public Is Ready for Major Action by the State Government Q HOW IMPORTANT IS IT FOR THE STATE GOVERNMENT OF MASSACHUSETTS TO TAKE SOME MAJOR ACTION TO ADDRESS RISING HEALTH CARE COSTS IN THE STATE? A Very Important 74% 88% Somewhat Important 14% Not Very Important 3% Not At All Important 1% MA State Government should not try to address rising costs in state 6% SOURCE: Blendon, R.J. et al., 2011. “Public Perceptions of Health Care Costs in Massachusetts.” BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 8
  • 10. Key Affordability/Cost-Related Developments in Massachusetts 2006 2007 2008 2009 2010 2011 2012  Health  Much of  Cost  Special  Government  Governor  Cost reform Chapter 58 Containment Commission reports and Patrick files Containment passes enacted, e.g.: Part 1 (Ch. on Payment hearings on payment Part 3? (Ch. 58) – MassHealth 305) passes Reform cost drivers reform – Begins path expansion – Increased – Recommends  Governor legislation to near – Commonwealth transparency move to rejects small  Special universal Care about cost global group Commission coverage – Consumer drivers payment premiums on Provider affordability – Reports on Price  Cost schedule health Reform insurer and Containment – New health Part 2 (Ch. plan options for hospital “reserves” 288) passes young adults – Aims to – Employer Fair control Share premiums for small business, individuals BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
  • 11. Technological Advances in Care Have Been a Major Driver of Health Care Spending Growth CONTRIBUTION TO GROWTH IN SPENDING 1960 – 2007 OECD COUNTRIES Using data from developed countries around the world, economists Technology estimate that advances in Income Effects medical technology 29% 26% explain up to about half of the total increases in real spending between 1960 and 2007; this is split evenly between 5% straight technological Medical Price advances in care, and the Inflation 27% fact that as income 7% grows, consumers Population Aging demand proportionally 11% Technology- more high tech care. Increased Income Interaction Insurance Coverage SOURCE: Smith S, Newhouse JP, Freeland, MS. “Income, Insurance, and Technology: Why Does Health Spending Outpace Economic Growth? Health Affairs 2009; 28(5): 1276-1284. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION
  • 12. Much of the Increased Spending on Medical Technology Has Bought Increased Health Value Technological advances in care have dramatically increased the costs of medical treatments. In Additional Health one study, economists Value found that the cost to Net Benefit of $70,000 Additional treat a heart attack rose Cost of $60,000 $10,000 between 1984 Treating and 1998. But the Heart Attacks improvement in care created $70,000 “worth” of health over the same period, measured as the dollar value of additional years of life gained by a Increase in Treatment Cost patient undergoing the $10,000 more advanced Heart Attack Treatment 1984 - 1998 treatments. SOURCE: Cutler, D.M. and M. McClellan, 2001. “Is Technological Change in Medicine Worth It?” Health Affairs, 20 (5): 11-29. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 11
  • 13. But Certainly Not All of It BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 12
  • 14. Health Care Technology – Especially Information Technology – Can Be a Major Health Care Cost-Saver $80 Billion in potential savings SOURCE:Hillestad, R et al. 2005. “Can Electronic Medical Record Systems Transform Health Care? Potential Health? Potential Health Benefits, Savings and Costs” Health Affairs, 24 (5): 1103-1117. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 13
  • 15. But Mere Installation of Technological Tools Will Not Yield Cost Savings Alone BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 14
  • 16. Increased HIT Adoption Could Be Cost-Saving or Cost- Additive in Massachusetts PROJECTED SAVINGS AS A SHARE OF SPENDING 2010–2020 Utilize bundled payment -5.9% -0.1% Institute hospital all-payer rate setting -4.0% 0.0% Institute regulation for academic medical centers -2.7% -0.2% Eliminate payment for adverse hospital events -1.8% -1.1% Increase adoption of HIT -1.8% 0.6% Institute reference pricing for academic medical centers -1.3% -0.1% Expand scope of practice for NPs and PAs -1.3% -0.6% Promote growth of retail clinics -0.9% 0.0% Create medical homes -0.9% 0.4% Decrease resource use at end of life -0.2% -0.1% Encourage value-based insurance design -0.2% 0.2% Increase use of disease management -0.1% 1.0% -7% -6% -5% -4% -3% -2% -1% 0% 1% 2% SOURCE: RAND. “Controlling Healthcare Spending in Massachusetts: An Analysis of Options.” 2009. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 15
  • 17. It’s All About Incentives The current payment system, called fee-for-service (FFS), rewards doctors and hospitals for doing more. This is doubly true for new medical technologies, as newer, high-tech services tend to garner higher payments. Providers also face few incentives to invest in information technology that could help reduce unnecessary use of health care. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 16
  • 18. Special Commission on the Health Care Payment System’s Recommendation CURRENT FEE-FOR-SERVICE PATIENT-CENTERED GLOBAL PAYMENT SYSTEM PAYMENT SYSTEM THE PROBLEM THE SOLUTION Care is fragmented instead of Global payments made to a group of coordinated. Each provider is paid for providers for all care. Providers are not doing work in isolation, and no one is rewarded for delivering more care, but responsible for coordinating care. for delivering the right care to meet Quality can suffer, costs rise and there is patient’s needs. little accountability for either. $ $ $ $ $ $ PRIMARY CARE HOSPITAL SPECIALIST HOSPITAL SPECIALIST PRIMARY HOME HOME HEALTH CARE HEALTH GOVERNMENT, PAYERS AND PROVIDERS WILL SHARE RESPONSIBILITY FOR PROVIDING INFRASTRUCTURE, LEGAL AND TECHNICAL SUPPORT TO PROVIDERS IN MAKING THIS TRANSITION. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 17
  • 19. Information Technology Will Be Key for the Success of Payment Reform Under global payments, providers will face greater incentives to invest in innovative technologies that help manage and coordinate care across settings. Provider groups accepting global payments will need tools and IT to help “divide the pie.” Insurers and providers will also need innovative ways to engage consumers in selecting high-value care. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 18
  • 20. But How Much We Pay – Prices – Is Just as Important as the Way We Pay for Care BCBSMA COST DRIVERS FROM 2004-2008 PERCENT OR INCREASE IN COSTS DUE TO CHANGE IN PRICE VS. PROVIDER/SERVICE MIX VS. UTILIZATION 100% 90% UTILIZATION (number of visits) 80% 70% PROVIDER MIX AND SERVICE MIX 60% 58.0% 53.3% 54.8% 53.8% 50% 40% 33.1% 30% UNIT PRICE (amount providers get paid) 20% 10% 0% NOTES: 2004 2005 2006 2007 2008 1) Reflects fully-insured commercial trend 2) “Unit price” reflects increases in provider rates. “Provider Mix and Service Mix” reflect changes in the location of care (shift to more expensive providers) and the intensity of services provided. “Utilization” reflects increases in the number of services provided. SOURCE: Office of Attorney General Martha Coakley, March 2010, “Investigation of Health Care Cost Trends and Drivers.” BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 19
  • 21. The Crux of the Current Political Debate Centers on the Appropriate Role for Government and the Market BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 20
  • 22. Stay Tuned…  Massachusetts has made health care “universally accessible, but not yet universally affordable…Massachusetts led the nation on health care reform and is poised to lead again on cost containment.” -Governor Deval Patrick  “…I think more immediately the issues of the health care debate and the budget really are going to require our attention” -House Speaker Robert A. DeLeo  “A careful, phased-in transition of this system-wide reform [removing fee- for-service within 5 years] is achievable. But we need to take the first step this year.” -Senate President Therese Murray BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION 21