Mike Leavitt: One of the reasons (alternative payment models are) growing slowly is because people don't know yet how to do it and the competencies are not yet developed. Payers—the federal and state governments being among the biggest—are going to have to continue putting steady pressure; if they put too much pressure, people will turn back. It's not going to be done solely with legislation. It's not going to be done in politics. It's going to be driven by economics and the market will begin to reshape and react to it.
Innovation will lead the way
Leavitt: It will be integrated systems, of which hospitals are only a part. They will be integrated systems that either own or are owned by a payer. It will be hospitals that have long-term-care assets, that have a physician practice and that have created the collaborative capacity to work together. I think you'll see device companies and pharmaceutical companies begin to step into this and say, "Wait a minute, we could be part of this. We can go from just being a chemical assembler—a pharmaceutical company—to a healthcare company and we could begin to take risk based on the validity of our product."
Daschle: The whole infrastructure landscape is going to change. Aetna CEO Mark Bertolini recently said the new models are not in the health field space. The models are Amazon and Tesla as the way we to look at healthcare and the way healthcare entities interact with people themselves. So I think you have leaders in the field who are trying to break out of the old mold and really redesign the whole notion of what healthcare will look like.