RIBGH summit to focus on reducing cost of care

Health care cost drivers and the importance of doctor-patient dialogue will dominate the conversation at the Rhode Island Business Group on Health’s annual summit on Oct. 17.
Attendants from throughout the business community will have a chance to examine the perspectives of health care providers, insurers and consumers in “plain English,” according to Al Charbonneau, the group’s executive director.
“There’s an awful lot of employee-benefit research out there … that says that employees look to employers to help them navigate the health care system,” Charbonneau said.
Dr. Al Kurose, president and CEO of physician group Coastal Medical and a guest panelist at the event, said the discussions are applicable across most business fields.
“I think for a long time now we’ve been hearing from the employers of Rhode Island that they feel stressed by the driving costs in health care,” Kurose said. “I think it’s a very timely, relevant topic for most employers.”
Don Nokes, RIBGH’s president, said this summit provides an opportunity for more members of the business community to get involved in conversations around health care.
“What’s missing, in my opinion, is the business perspective,” said Nokes, president of Warwick-based information technology company NetCenergy.
Cost and Waste in Health Care
Representatives of local hospitals and hospital networks, insurance carriers and several statewide health care organizations will lead morning discussions. Panelists in three different sessions will talk about what factors are driving costs in their organizations, and what they are doing about it.
Morning panels will include insurance companies Blue Cross & Blue Shield of Rhode Island, Tufts Health Plan and UnitedHealthcare of New England; hospital systems and providers Care New England, Lifespan and South County Hospital, and statewide organizations CSI-RI, CurrentCare and Coastal Medical.
During the lunch hour, CVS Health Associate Medical Director Dr. Andrew Sussman will speak, followed by U.S. Sen. Sheldon Whitehouse. In the afternoon, a presentation on the Choosing Wisely campaign will be followed by a panel discussion with representatives from Amica Mutual Insurance, Blue Cross and Brown University.
Dennis Keefe, president and CEO of Care New England and another guest panelist, said he will present the company’s ongoing implementation of electronic record system EpicCare Ambulatory. Keefe expects the system will reduce redundant lab tests and procedures.
“We think as we fully deploy that electronic health record across our systems, throughout hospitals, throughout our emergency rooms, that’s going to be extremely helpful in eliminating a lot of waste and duplication,” Keefe said, adding that health-information exchange CurrentCare – which will be represented on another panel at the summit – is the only similar tool available to Care New England facilities. “Within a couple of years, we will have all of that information at everyone’s fingertips.”
Panelists will also touch on moves to mitigate costs that may incur as insurers increasingly move away from fee-for-service payments to more set reimbursement models – a shift that moves risk onto providers. For Care New England, its population health-management plan includes strategic partnerships like the mental health bundle-payment initiative it has formed in collaboration with Blue Cross and The Providence Center.
“A lot of it is really trying to keep people out of the hospital,” Keefe said.
Kurose of Coastal Medical said the best initiatives address the triple aim of improving health care quality, patient experience and cost efficiency – initiatives like Coastal 365, which allows members’ patients to see urgent primary care physicians any day of the year.
Other topics may cover employer-sponsored wellness programs, other financial initiatives to improve efficiency or projects designed to improve health care quality in areas like infection rates, according to Charbonneau.
A Well-Informed Patient is a Good Patient
The afternoon will give way to a presentation on Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation and its many specialty-organization partners that aims to enable patients to make informed decisions about their health care. When Choosing Wisely partners with an organization like Rhode Island Business Group on Health, it provides extensive consumer-oriented informational materials, according to Dominic Lorusso, director of health partnership for Consumer Reports, another key participant in the initiative.
With Consumer Reports staff help, Choosing Wisely members have access to materials on topics such as “Antibiotics: When You Need Them and When You Don’t,” or “Medical Tests Before Surgery.” The consumer-friendly information in each pamphlet is intended to prompt a more informed discussion between patients and doctors – not to be taken as medical advice.
“The important point of this is that we need to be careful about overuse and overtreatment,” Lorusso said. “There are times when the treatments are required; there are times when they are not. … It’s not really acceptable anymore for people to kind of just blindly go through that process, because it is important that they take their health care into their own hands. Patients need to know what they’re getting into. They need to be engaged, they need to work with their physician.”
While the campaign’s focus is on consumer education, Charbonneau said a well-informed patient is important to discussions on cost-efficiency.
“People feel, and I’m one who thinks this is correct, that an informed consumer can really help drive better quality and lower cost in the system,” he said.
Projects like Choosing Wisely and conversations about cost control all point to the national movement of health care away from a condition-oriented treatment model.
“It’s very different from what hospitals have done historically. ‘We treat you when you’re ill, and we do all kinds of procedures, and we get paid for all of that,’ ” Keefe said. “[Now] it’s all about health, it’s all about partnering with patients. It’s all about increasingly moving the walls of the hospital into the community.” •

No posts to display