LAS VEGAS--As the healthcare industry undergoes a transformation, health plans must lead the way by promoting consumer-driven healthcare, delivery system reform and technology that challenges the status quo, America’s Health Insurance Plans CEO Marilyn Tavenner said in opening remarks at this year’s AHIP Institute.
Insurance companies, according to Tavenner (right), are uniquely equipped to see across the entire system--and thus, have the responsibility to be consumers’ best advocate.
“We are in a position to translate this vast array of data that exists about procedures and providers, and turn it into something understandable and usable for patients,” she said.
To the first point, Tavenner noted that today nearly every health plan offers simple, innovative cost and quality tools to guide consumers. But even so, she added, “I am confident that this is an area that we can accelerate in the years ahead.”
And when it comes to delivery system reform, health plans must encourage a diverse array of stakeholders working toward achieving value rather than maximizing volume, she said. “Our job as an industry is to greater position practices, hospitals, pharmaceutical companies--and, ultimately, consumers--along with us on this journey."
One way AHIP has furthered that goal is through its work with diverse stakeholders to create seven core sets of quality measures. Aligning quality measures across the system, she noted, helps to close the many gaps in care.
Tavenner also pointed to Medicaid managed care plans as a model for health plans that want to take a holistic approach to coordinating care and delving into social determinants of health. They have been particularly effective, she noted, at integrating medical and behavioral healthcare for this uniquely challenging population.
Thus, just as it has done for Medicare Advantage, AHIP aims to be “increasingly vocal” about the value of Medicaid managed care, Tavenner added.
As for technology, Tavenner noted recent research indicates reliance on healthcare scorecards, consumers’ use of technology to measure fitness, health and treatment goals, and use of monitoring tools among patients with chronic conditions has all increased in recent years.
“These data points point to real opportunities to help people transform their lives using new, emerging technology,” she said.