That seems like it’s where we should put all our energy.Īre incentives aligned to use technology to improve care? I get a little bit sickened every time I go to HIMSS, in some part, because we’ve got this massive industry that puts on a great party and has massive shows, and yet they have a customer base that is basically unsatisfied with the product. We need to be very honest about what it’s not doing. I don’t think anybody should lose promise in the power of what technology can do and that that investment will eventually pay off.īut if not, we need to be very honest about the barriers. We clearly, though, have productivity breakthroughs, Moore’s Law breakthroughs, and other breakthroughs ahead of us. We’ve got computers and it’s just basically fancy ways of writing down what we used to do in pen and paper. We’re sort of like using computers pre-Internet, wondering why our factories aren’t getting more productive. It’s probably not improving care.īut remember, before the ARRA, we didn’t even have the means to have the technology to hook up. It’s not satisfying the clinicians in general. It’s not as connected as it should be, it’s not giving people the information they need. You walk into a doctor’s office, you walk into a hospital, they have technology there. Here’s what we’ve accomplished - and I’m sure you could agree or disagree and have as much knowledge base if not more than I do on this topic - but there’s now what I call a chicken in every pot. Of course it can be made better if people really put the spirit to it.ĭid we as taxpayers get our money’s worth in funding $35 billion in EHR incentives? Because when things happen, they will have the out-of-pocket max and then they have no limit in terms of what’s covered. I do think that the package of things in the ACA - given what you said earlier, which is that we have to work on unit cost and healthcare is still too expensive - is a darned good package for people and really valuable. I’m not a believer that higher deductibles make people better shoppers. Particularly, again, of the middle-class people that people are paying attention to, but it’s about 2 percent of the population as a whole that’s showing these higher deductibles. There’s this mass media perception driven by, I think, a lot of propaganda which isolates several of the stories. They’re about flat, but they have actually declined from 2015 to 2016. deductible and co-insurance, have declined every year slightly. There’s a whole package of things.īy the way, cost-sharing reductions have meant that up at least until 2016 - I haven’t seen the data for 2017 - the average out-of -pocket costs, i.e. Lesser numbers, you can see specialists and have name-brand drugs outside of the deductible. About two-thirds have prescription drug coverage outside of the deductible. About the same number - actually it’s more than that, it’s about 80 percent of policies, last I saw - you can get three primary care visits outside your deductible. Two-thirds of policies have primary care outside of the deductible. ![]() There’s meaningful numbers of people who say they are satisfied and can sleep better at night because of coverage. There’s meaningful differences in the number of people who report having a regular relationship with a primary care physician than before the ACA. There are meaningful differences in the number of people today that say they can afford to take their medications - and do take their medications - than before the ACA. in how you’re characterizing what insurance looks like and feels like to people. You’re right in the fact that we don’t have a functioning market that people make rational decisions because they’re paying out of pocket. ![]() Studies suggest that didn’t happen, that instead people who can’t afford to pay the deductible are avoiding getting care. Topics in Part One included perceptions of the healthcare system, high healthcare prices, doing a better job of explaining the Affordable Care Act, risk pools, and the individual mandate.Įxperts thought high-deductible plans, which is a lot of them these days, would encourage people to become wiser healthcare consumers. This is Part Two of the lengthy interview. Andy Slavitt, MBA was acting administrator for the Centers for Medicare and Medicaid Services from March 2015 until January 2017.
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