Presented April 16, 2021 by the Miami Herbert Business School Center for Health Management and Policy, the 10th annual Business of Health Care Conference focused on Policy, Politics & the Pandemic – U.S. & Beyond. The conference consisted of three panel discussions plus breakout sessions and sponsor presentations. The second panel, entitled Policy and Patient Care: A View from Health Care Leaders, featured heads of the leading US professional health organizations including Susan Bailey, president, American Medical Association; Matthew Eyles, president and CEO, America’s Health Insurance Plans; Joseph Fifer, president and CEO, Healthcare Financial Management Association; Halee Fischer-Wright, president and CEO, Medical Group Management Association; Ernest Grant, president, American Nurses Association; and Lisa Kidder Hrobsky, group vice president, Federal Relations, American Hospital Association.
The discussion got off to a sobering start as the panelists discussed the situation on the ground as we (hopefully) transition to a post-pandemic world in the coming months. Ms. Kidder Hrobsky noted that the combination of PPE expenses, elevated labor costs and revenue loss was devastating. “The relief government provided was a lifeline,” she stated. Dr. Grant pointed to the mental health impact on healthcare workers. According to his organization’s Pulse Survey, practitioners are overwhelmed and depressed, not eating or sleeping well. Even more concerning is that same survey found 15% of the nurse respondents are planning on leaving the profession. Dr. Bailey stated that physicians are often reluctant to seek counseling due to the stigma surrounding mental health. Circling back to the financial impacts, Dr. Fischer-Wright noted that rural health systems, already struggling pre-pandemic, were really hit hard by COVID. Mr. Fifer stated that some health systems were losing over $100,000,000 a month in the peak of the pandemic.
Next the conversation turned to getting ready for the immediate future. Dr. Fischer-Wright asserted that practices are seeing a big change in payer mix. Meanwhile, practitioners are retiring early due to COVID; so labor supply will be tight. “Practice models will have to change.” Meanwhile, Dr. Bailey reminded the audience that the hybrid telehealth model is here to stay. “It kept our practice alive,” she stated while marveling at the speed telehealth advanced due to the health crisis. “Ten years of telehealth development was completed in ten months.” She also asserted that CMS must make the telehealth reimbursement provisions permanent.
Mr. Fifer led the talk to value-based-care (VBC). “The models have no uniformity. They appear to providers as a black box.” That said, Mr. Fifer conceded that most studies are showing that VBC practitioners fared better than fee-for-service (FFS) providers during the pandemic. Ms. Kidder Hrobsky echoed Mr. Fifer’s ambivalence toward the VBC model. “There’s a lot of fear out there,” she stated. “There is a sense that FFS has to be replaced but, at the same time, there is a lack of confidence in the risk (VBC) models.” And Dr. Fischer-Wright pointed out those still in FFS have no bandwidth for VBC adoption during COIVD. She likened the current situation to Maslow’s Hierarchy of Needs where basic needs must be met before others can be satisfied. “Providers are just trying to survive the crisis,” she stated. Mr. Eyles insisted that despite the negatives associated with VBC, the way forward is clearly not FFS. He reminded the audience that VBC practitioner did better during the crisis and therefore favors accelerated adoption.
In what has become an annual ritual during this segment of the program, the panel’s moderator asked the speakers to confirm their support for the Affordable Care Act. The response was unanimous in the affirmative. However, a follow up query regarding support for the Public Option – a proposed program whereby individuals below the minimum age for Medicare benefits could buy into the program – there was no such consensus.
As we enter the next chapter of the global health crisis, the view from this group of healthcare leaders is cautiously optimistic. There are many ongoing challenges and unresolved health policy issues. New technologies, innovative payment models and the right policy prescriptions offer hope that the post-pandemic healthcare landscape will be brighter than the one we live in now.
The Miami Herbert Business School offers several academic programs focused on health management including:
- Health Executive MBA (HEMBA) – A top-ranked, fast-track weekend program that prepares health care executives for new leadership roles across the industry
- Master in Health Administration (MHA) – A full-time, 12-18 month program that blends business fundamentals with health care specific topics and hands-on training
- MD/MBA – A program that prepares future physicians to run medical practices and assume other industry and policy leadership roles
- Undergraduate Specializations – Undergraduate students may seek majors and minors in health management and policy
To learn more, please visit https://herbert.miami.edu/.