Payment reform requires feds, private insurers to align

The best chance of achieving real payment reform requires the federal government aligning its programs with private sector initiatives, insurance execs said at the 1st Annual Health Care Summit, reported Bloomberg BNA. "What we need to do is align innovation in Medicare … with innovation in the private sector," said Scott Serota, CEO of the Blue Cross and Blue Shield Association. "We need to open up our minds on both sides and say, how can we take that which is already working in the private sector and apply it in the Medicare sector," he added.

Sam Nussbaum, executive vice president of clinical health policy and chief medical officer of WellPoint, agreed. "It is going to be payment reform that I think ultimately will make the most profound difference in the near term," he said. Another key driver to successful payment reform is removing "the administrative barriers, the regulatory barriers … so that we can allow payment innovation to drive better quality care and more integrated care," Nussbaum said.

Likewise, Aetna's accountable care solutions CEO, Charles Kennedy, said more regulatory efficiency is necessary to overcome barriers to innovation, including taking up to 14 months to obtain state approvals for new health plans that incorporate accountable care organizations. But he remains optimistic, believing that "innovation centered around value, which is what's been missing in the health care system, may finally be here." Article

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