Losing patience

Sunday, July 01, 2018 12:24 PM

Denver Metro Chamber brings business community together to tackle rising costs of health care

by Chet Seward, Senior Director, Division of Health Care Policy

The business community is fed up with the rising cost of health care and is taking action. While this issue has been a pain point for years, it has reached a critical stage fueled by recent activity by the Denver Metro Chamber of Commerce (DMCC) and more and more data show seemingly inexplicable variations in care and prices across the state. DMCC is leading an effort to immediately slow the rate of cost growth and sustain those changes over time using voluntary, regulatory and legislative proposals.  It is essential that physicians continue to remain actively involved in efforts to decrease health care costs and improve quality.

Growing concerns

While health care cost growth has slowed over the past eight years, that growth still far outpaces inflation. More importantly, overall costs are at record levels ($28,000 a year for a family of four) and are squeezing out personal pay raises, business spending on growth and public-sector funding on priorities like transportation, education and jobs. Odds are you are hearing concerns from both your patients and your practice’s HR department. Cost increases are now challenging the competitiveness of Colorado employers. The results of recent member focus groups by the DMCC underscore the extreme level of frustration and distrust of the health care industry by employers and employees, with some commenters worrying that their monthly health insurance premiums now cost more than their mortgage, others demanding full transparency on costs, and others calling the current system “a racket” and full of “cartels.”

Pressure to act

This spring the DMCC convened a coalition of health care stakeholders, including insurers, hospitals, pharma, the bio-science industry and physicians, to develop recommendations to decrease the cost of care and improve quality. The Colorado Medical Society (CMS) signed on from the start, viewing the chamber’s efforts as a unique opportunity to showcase and accelerate ongoing physician efforts. DMCC CEO Kelly Brough presented to the CMS board of directors in March on the initiative, underscoring the intense pressure the DMCC is under to take meaningful action. She made clear that the DMCC intends to move forward with a suite of voluntary, regulatory and legislative actions in 2019, whether or not there is consensus within the coalition. Moreover, DMCC will share results of this work with other chambers of commerce around the state to grow support for this effort.

Over a series of meetings, the coalition developed a slate of 95 proposals to contain costs while ensuring quality. At press time these ideas, which range from data and transparency, to reimbursement and workforce, were continuing to be refined and winnowed. Co-chair of the DMMC coalition Bill Lindsay emphasized the urgency and breadth of these recommendations: “Chamber members are saying that they want to see something happen now, not later. We are not talking about just legislation, we want to affect the market by using the market.”

Denver-area radiologist and CMS representative to the coalition Peter Ricci, MD, said the focus has been on driving cost containment, improving quality, and ensuring that recommendations don’t make things worse and can be controlled by Coloradans. “There were a lot of ideas offered as potential solutions from the start. As discussions have progressed, they have sometimes become intense on topics like drug prices, hospital and health plan profits, the complexity of health care pricing, transparency and the need for uniform quality metrics and different payment models to drive better value,” he said. “But, there have also been areas of near universal agreement, including the need for better data to inform our decision making.”

Physicians step up

“As physicians, we recognize that on so many levels the current system is too costly, and that continued increases in the cost of care threaten our patients and our state, which is why bringing our profession’s collective voice to the table is essential,” Ricci said. Almost 40 presidents of component and state specialty societies, as well as chief medical officers from major hospital systems, met in early May to gain a sense of priorities regarding DMCC cost containment proposals. Outcomes from the meeting were shared directly with the DMCC and helped to spur the development of a special CMS work group to help accelerate physician efforts to reduce costs and improve quality.

While the profession is being proactive, much work remains and patience by the business community is wearing thin. If you have stories to share about your efforts or would like to participate, please contact CMS Director of Health Care Policy Chet Seward at chet_seward@cms.org. A business-medicine coalition to drive meaningful cost containment and quality improvement efforts would be a powerful force for change at a time when it is clearly needed.