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Disruptive Innovation & Healthcare Reform: What's Ahead?

Disruptive Innovation & Healthcare Reform: What's Ahead?. Paul H. Keckley , Ph.D., Executive Director for the Deloitte Center for Health Solutions. U.S. Health System Reform. Paul H. Keckley, Ph.D. Executive Director Deloitte Center for Health Solutions.

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Disruptive Innovation & Healthcare Reform: What's Ahead?

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  1. Disruptive Innovation & Healthcare Reform: What's Ahead? Paul H. Keckley, Ph.D., ExecutiveDirector for the Deloitte Center for Health Solutions

  2. U.S. Health System Reform Paul H. Keckley, Ph.D. Executive Director Deloitte Center for Health Solutions Chicago, Illinois ~ March 24 & 25, 2009

  3. Budget Director Pick Sounds Alarm(Orszag Confirmation Jan. 13, 2009) • “The principal cause of the nation’s long term budget problems is rising health costs”.

  4. The public view: “The system is confusing…” • Only 3 in 10 consumers feel they know how the U.S. health care system works. Source: 2009 Survey of US Health Consumers

  5. The public view: “The system isn’t working very well…” • Only 1 in 5 consumers give the U.S. health care system an above-average report card grade; those grading the system “F” outnumber those giving it an “A” by 6 to 1. Source: 2009 Survey of US Health Consumers

  6. The American Recovery and Reinvestment Plan: $787 billion

  7. Stage One:2009-2011 Stimulus Package Inclusions Focus will be expansion of benefits to newly unemployed, executive orders that extend coverage (SCHIP 2/2/09) and jobs related programs In additon, certain programs that buoy states against expected increases in Medicaid enrollment A few campaign promises: EX. HCIT Long term: health reform in two stages • Stage Two: 2010-2016 • Systemic Reforms—Long Term • Insurance market reforms • Individual mandate + employer pay or play + FEHP2 • Comparative effectiveness • Episode based payments • Medical Home • Expansion of role: FDA, CDC • Medicare eligibility • Federalization of Medicaid

  8. Message to Congress February 24, 2009 • Energy, education and health care: focus of systemic reforms • Two consistent themes: • Reduce costs • Expand coverage

  9. FY10 Reserve Fund Proposal $634 B • FY 10 Budget Preview - February 26, 2009: $634B 10 year health care investment to fund coverage for uninsured & underinsured • Funding from… • $318B tax increases (mortgage deduction decrease, Medicare premium increases for wealthy enrollees, $250K HH tax cuts eliminated 2011) • $177B from Med Part D Competitive Bidding • $139B lower payments including $24B Hospital Bundled Payments -- ($17B) and Substandard care ($8B)

  10. Key Players ARLEN SPECTER: Senior Senator from Pennsylvania CHUCK GRASSLEY: Senior Senator from Iowa TED KENNEDY: Senior Senator from Massachusetts MAX BAUCUS: Senior Senator from Montana MIKE ROSS: Member of the U.S. House of Representatives from Arkansas's 4th district ROY BLUNT: Member of the U.S. House of Representatives from Missouri's 7th District PETE STARK: Member of the U.S. House of Representatives from California's 13th district HENRY WAXMAN: Member of the U.S. House of Representatives from California's 30th district

  11. Key Players KATHLEEN SEBELIUS: United States Secretary of Health and Human Services – Nominee NANCY-ANN MIN DEPARLE: Director of the White House Office on Health Reform

  12. Long term reforms focus in four areas • Respond to transparency & PC 2.0 • Connected care • Rx reimportation • Medical tourism • PHR (Shared Decision Making) • Incentives • Experience rating & differential premiums • Healthy behavior rewards • Complementary/Alternative Medicine 6 year implementation 1:8 to 1 ROI Savings: $530B (NPV) Balance: cost and quality 4 Consumerism Focus: CDHPs, Transparency, PHRs, Incentives, Value Coordination of care Focus: Primary Care 2.0 Model (The New “Medical Home”) • New medical homes • Reimbursement realignment • Primary care workforce • MD led clinical care coordination 3 • 3 – 7 NMEs per year • Center for comparative effectiveness • Knowledge management • Prepare for tort reform Comparative Effectiveness/ Evidence – based Medicine Focus: (1) Personalized medicine, (2) comparative effectiveness; episode based payments to acute organizations 2 • Decreased errors • Decreased care gaps • Reduced malpractice premiums • Improved efficiency Health Care Information Technology Focus: (1) e-prescribing, ( (2) care coordination (3) administrative cost reduction 1

  13. Contact Information For more information, please contact: Paul H. Keckley, Ph.D., Executive Director pkeckley@deloitte.com For more information on the Center's view of health care in the new administration, please visit: www.deloitte.com/us/healthcarereform And visit our website to subscribe to our content: http://www.deloitte.com/CenterforHealthSolutions/subscribe Center for Health Solutions

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