Dr paul keckley paul h keckley ph d deloitte center for health solutions washington dc
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Dr. Paul Keckley Paul H. Keckley, Ph.D. Deloitte Center for Health Solutions Washington, DC. KEYNOTE: Health Reform – What does it mean for SE Michigan? What can we do?. The US health system: big, complex, fragmented, uneven…. ADMINISTRATORS/WATCHDOGS. Regulators. Media. Professional

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Dr. Paul Keckley Paul H. Keckley, Ph.D. Deloitte Center for Health Solutions Washington, DC

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Dr paul keckley paul h keckley ph d deloitte center for health solutions washington dc

Dr. Paul KeckleyPaul H. Keckley, Ph.D.Deloitte Center for Health SolutionsWashington, DC

KEYNOTE:

Health Reform – What does it mean for SE Michigan? What can we do?


The us health system big complex fragmented uneven

The US health system: big, complex, fragmented, uneven…

ADMINISTRATORS/WATCHDOGS

Regulators

Media

Professional

Societies/

Special Interests

BIOTECH

Insurers

INNOVATORS

Academic

Medicine

Pharma

BioTech

Accrediting

Agencies

Employers

HCIT

Device

SERVICE PROVIDERS

Hospitals

Long Term

Care

Outpatient

Facilities

Allied Health

Professionals

Disease

Management

CAM

Physicians

CONSUMERS


Costs access and quality are major issues

Lack of capital and resources

Explosion

in clinical knowledge

Lack of

consumer involvement

Lack of

appropriate technology

Lack of incentives for right behaviors

Lack of trust among Key Players

Lack of

political will, leadership

Costs, access and quality are major issues!

Runaway

Costs

Uneven

Access

CHANGE

Poor

Quality


The majority support reform two in five rate the system unfavorably

The majority support reform: Two in five rate the system unfavorably

Unfavorable report card grades are more likely among Gen X and Boomers (4 in 10) than among Gen Y and Seniors (3 in 10)


Dr paul keckley paul h keckley ph d deloitte center for health solutions washington dc

Most do not understand the “system” and believe it is wasteful. Insecurity about health costs is high:Seniors “in public plan” most favorable.

Source: 2009 Deloitte Survey of US Health Consumers, Deloitte Center for Health Solutions


Public opinion about health reform deloitte pulse survey september 10 13 2009

Public opinion about health reform (Deloitte Pulse Survey, September 10-13, 2009)

  • 54% of U.S. adults believe health care reform will not pass this year vs. 41% who do

  • 48% believe the U.S. health system needs a major overhaul—among the uninsured (60%) and underinsured (55%)

  • 73% of respondents believe it is important for every American to have health insurance but 55% do not believe coverage for the uninsured should be the sole focus of the debate

  • The most trusted sources to reform health care are providers (37%), the White House (21%), Congress (13%), employers (11%) and health insurance companies (7%)

  • 61% believe that Congress is likely to make the health care situation worse than better

  • 55% believe government solutions to health care will cost more and deliver less compared to private sector solutions.

  • 51% believe health reform should not wait until the economy is better compared to

  • 47% who thought it should wait.


White house 1 domestic issue reduce costs cover everyone

White House #1 domestic issue: Reduce costs, cover everyone

  • February 24, 2009 to joint session of Congress: Reform energy, education and health care. Pass bill in 2009.

  • May 11, 2009 to major trade organizations: Cut CAGR to 4.7%, reduce costs by $2 trillion (2008 – 2018).

  • June 3, 2009: Everything on the table—mandates, employer tax exclusion, employer mandate, public plan, etc.

  • September 9, 2009: President Obama’s address to joint session of Congress, reiterating commitment.

  • White House messaging:

  • Reform is necessary to create competition in the insurance market

  • Reform is necessary to economic recovery

  • Reform is a moral imperative

  • Reform must be deficit neutral


Looking ahead a bill in december 2009 900 billion

Looking ahead…a bill in December 2009 (~$900 billion)

  • Major elements of the “Kennedy” reform bill--

  • Access--Individual mandate, Medicaid expansion, employer mandate

  • Quality—comparative effectiveness, episode-based payments, transparency

  • Cost—insurance regulation, health exchanges

4

  • Major Sources of funding

    • Medicare cuts

    • Industry fees

    • Cadillac plans

    • Income taxes

Consumerism

Focus:

Self care

Achieves $ TBD

Primary Care 2.0

Focus: Prevention, Chronic, LTC

Achieves $24-57B/yr savings

3

Comparative Effectiveness/EBM

Focus: (1) Personalized medicine, (2) bundled based payments, (3) provider adherence/performance-based payments

Achieves uo to $30B/yr savings

2

Health Care Information Technology

Focus: (1) e-prescribing, (2) fraud detection(3) administrative cost reduction , (4) care coordination

Achieves $33-70 B/ yr savings

1


As of october 15 40 proposals 3 major bills

As of October 15—40 proposals, 3 major bills


In southeast michigan what if

In southeast Michigan, what if…

  • Every price for every healthcare transaction was known before the purchase?

  • Every treatment recommendation was based on evidence ?

  • Every dollar spent for facilities and technology necessary?

  • Every person knew as much about the industry as they know the auto industry?

  • Every person lived a healthier life and managed their own care?


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