The leader of North Carolina’s largest health insurance company said collaboration, innovation and cooperation are necessary to improve the quality and lower the costs of health care.
Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina and a 1975 graduate of Appalachian State University, presented the talk “Prescription for a Better Health Care System on Friday at ASU’s Holmes Convocation Center. The talk was co-presented by the Walker College of Business’ Harlan E. Boyles Distinguished CEO Lecture Series and the new College of Health Sciences BCBSNC Distinguished Lecture Series.
Wilson said the nation currently spends more than $7 billion a day on health care, and that at the current rate, health care will represent 20 percent of U.S. gross domestic product by 2020.
“That is an unsustainable economic model for this nation,” Wilson said. “We are not getting the value out of the $7 billion we’re spending,” he added, noting the U.S. ranks far behind other developed countries on metrics such as life expectancy and healthy weight.
Wilson advocated for a new “patient-centered” and “collaborative” health care model with rewards based on health outcomes, and he pointed to Carolina Advanced Health — a project of BCBSNC and the University of North Carolina — as an example. The Chapel Hill medical office focuses “on the total person” with doctors, a physician assistant, nurse, nutritionist, behaviorist, clinical pharmacist and case manager all under one roof — “a one-stop shop,” Wilson said.
“It’s getting dramatic results,” he said, noting that the project’s patients were achieving better health outcomes than those not in patient-centered care.
Accountable care organizations are another innovation that could lead to a better health care system, Wilson said. ACOs are groups of doctors, hospitals and other providers who coordinate patient care to avoid unnecessary duplication of services and medical errors, according to the U.S. Centers of Medicare & Medicaid Services. As an incentive, doctors and providers get a share of the money saved, he said.
Another effort Wilson mentioned is the episodic bundled payment, under which a health insurance plan pays a hospital a set rate for an entire episode of care, and it’s up to the hospital to manage that payment efficiently, he said.
Wilson said consumers must play a more active and engaged role in shopping for health care, asking the audience if they knew in advance what the cost of their last medical procedure would be. He urged consumers to shop for the best value in health care by comparing prices and data on outcomes.
“All of us in the health care system have not made that readily available to you,” he said, but “that is changing.”
Forbes magazine estimates that a lack of information about health care costs drives up spending by $100 billion a year, said Wilson.
Wilson did not openly criticize the Affordable Care Act but did not express enthusiastic support for it, either, though he did praise its emphasis on preventative care.
“It is indeed the law of the land until it is not,” Wilson said.
Date: October 28, 2013