Tavenner urged attendees to help educate their friends, family, patients and colleagues about the insurance exchanges, where people with incomes under 400% of the poverty level can buy subsidized coverage and others will be able to sign up for expanded Medicaid coverage. With women making 80% of healthcare decisions, “I think this is an easy mission for all of us,” she said.
But she added that while half the focus of the Patient Protection and Affordable Care Act is on expanding health coverage, the other half is on controlling healthcare costs. “One of the criticisms of Massachusetts (which established an Obamacare-style system in 2006) is that they did a great job with access, but they didn't deal with the cost,” she said. She acknowledged that Medicare has seen the lowest cost trends of the past 50 years, but added, “We will have to stay focused on costs.”
Reducing cost growth was also one of themes of a panel on blending cultures after a merger or acquisition.
Judith Persichilli, interim president and CEO of CHE Trinity Health, whose merger went live in May, said that operational efficiencies were not where the merged systems saw the most potential for savings. “The real savings are in clinical transformation,” she said, citing the focus on behavioral health in the Pittsburgh market.
Panelist Keith Pitts, vice chairman of Vanguard Health Systems, which recently announced a merger with Tenet Healthcare Corp., said providers need to take out 20% of the total cost of care.
He focused on one of Vanguard's most recent takeovers, Detroit Medical Center. “Everyone wants to know: Why would you buy Detroit Medical Center?” he said. “Detroit wasn't a broken health system from an operating standpoint. But they didn't have any capital. They were scrappy, but they didn't have any cash.”
That 2010 acquisition allowed Vanguard to inject funding for deferred projects. “If you drive around Detroit, you'll see cranes up,” he said. “Most of those cranes have our name on them.”
Detroit Medical Center, a safety net hospital for southeast Michigan, also applied and was selected to be a Medicare Pioneer accountable care organization. “We did save 4.5% the first year so we stayed in a second year,” he said. “The health status of Detroit is one of the toughest in the country. I see a very bright future in Detroit in being able to accomplish that.”
The event celebrated Modern Healthcare's Top 25 Women in Healthcare, a biennial list of visionary female leaders in fields including health policy, government, health systems, payers and medicine.