Emanuel has published this new book. He was a key advisor in the White House on the ACA legislation. I had the pleasure of hearing him provide a summary of his book earlier this week. Here are six megatrends that he forecasts for the future.
1) Insurance companies will make greater use of management, analytics, and actuarial services and/or integrated delivery systems
2) Doctors and hospitals will focus on keeping chronically ill out of ERs and hospitals and provide more effective mental health care
3) Many hospitals will close and digital systems will become more widespread
4) Employer participation in health insurance will be dramatically reduced.
5) Health care inflation will be significantly reduced
6) Medical education will be dramatically transformed.
I feel there is a much wisdom and potential reality in these points. Here are some of my thoughts that I shared with him afterwards in which he seems to have concurred:
What do you think of Pay for Performance strategies which are now part of the Medicare program? I think they have potential but have not seen clear evidence so far to support.
I think the Hotspotters as discussed by Atul Gawande has great merit and ties in with your thoughts on chronic care.
I think it would be very useful to incentivize consumers to select insurance plans based on quality of care measures. General Motors tried such an approach successfully a number of years ago.
There is a great need to integrate post-acute systems and also to integrate long term care systems. In addition, to integrate care for dual eligibles.The administration is working on the latter but has not shown a great deal of creativity.
I also think the administration needs to do a better job of selling the accomplishments so far and counter the Republicans more effectively.
II. The Alliance for Health Reform held a very useful session yesterday on Prevention. There are many positive features in ACA regards prevention but there is much more that can be done from a system viewpoint as well as re funding.
III. Other articles
Here are other items of interest
Maryland to shift $21m to help stabilize insurance premiums
CBPP Releases New Resource on State Marketplace Design and Policies
Are Exchanges More Appealing To Insurers Now?