Document: Health Policy Conference Features Foremost Health Policy Leaders : ERIC

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	Meetings and Conference Calls

Health Policy Conference Features Foremost Health Policy Leaders

ERIC's Health Policy Conference held June 11 in Washington, DC, featured many of the nation's leading health policy stakeholders who discussed consumer directed health plans, the Patient Centered Medical Home, designing and implementing wellness programs, health care reform proposals, compliance with new legislation, and cutting edge strategies in employee benefits.

Consumer Directed Health Care

Aon Consulting's Bill Sharon led a discussion with Jeff Lemieux, Senior Vice President for America's Health Insurance Plans and Chris Jacobs of the House Republican Study Group. Sharon discussed the various "myths versus realities" with consumer directed health care and how many critics are missing the point. He said that CDHC involves more consumer engagement, and that changing consumer financial engagement does not necessarily involve cost shifting, as there are a wide range of plan designs that can be used. Sharon added that one of the main points with CDHC is teaching people how to be better consumers and how this will lead to better health care results.

AHIP's Jeff Lemieux discussed the growth in enrollment in health savings accounts and high deductible health plans, the types of plans consumers are enrolling in, and other demographics. Chris Jacobs provided the Republican perspective on health savings accounts and how they seem to be political hot buttons. Jacobs believes Democrats are hostile to HSAs, and pointed to a recent proposal that would require substantiation of all HSA expenses to an extent that is greater than in similar situations.

Inefficiencies in Isolation: Stand Alone vs. Coordinated Care Programs

Andrew Webber, President and CEO of the National Business Coalition on Health, moderated a panel that featured Tracey Moorehead, President and CEO of DMAA: The Care Continuum Alliance, and William Wynne, Health Counsel with the Senate Finance Committee. Webber discussed how employers want improved workforce health and productivity, greater control of the costs associated with illness and disability, and opportunities for improvement. Webber highlighted principles to follow to help integrate coordinated care systems, such as evidence-based treatments, disease registries and patient tracking, and behavior modification. Webber referred attendees to the PCPCC's recently released Purchaser Guide to obtain additional information on what employers can do to help implement change.

William Wynne said that Congress has been monitoring developments on care coordination and disease management, and how there is strong evidence that care coordination works in some areas, but not necessarily in Medicare. He said they are looking at ways to improve effectiveness, and pointed to provisions in the Senate's Medicare physician payment legislation that expands the Medicare Medical Home Model demonstration projects, and asks MEDPAC to look into the matter.

Tracey Moorehead contended that disease management is an outmoded label and how there is a changing landscape in the growth of prevention and wellness programs, with advances in program design, and an expanded role for health IT and the need for interoperability. According to Moorehead, the three core components for health improvement are central care delivery and a leadership role of the primary care physician; improvement of patient activation and personal responsibility; and expanded care coordination for wellness, disease and chronic care management.

Designing and Implementing Wellness Programs

Sue Lewis of IncentOne moderated a panel with Covington & Burling's Amy Moore, and James Murray, Executive Director of US Outcomes Research for Merck & Co., on designing and implementing wellness programs.

Lewis presented the preliminary findings of the ERIC/NAM/IncentOne survey on the use of incentives with employee health, wellness and disease management programs. Among the key findings were that health and wellness programs continue to grow, with 77 percent of large employers currently offering formal health and wellness programs, and more than half of those without programs planning to add them within one year. Lewis also said that some employers are beginning to successfully measure return on investment for health and wellness programs, but that measuring program effectiveness continues to remain a key challenge.

Covington & Burling's Amy Moore discussed the legal issues in designing and implementing wellness programs. Moore provided an overview of the nondiscrimination requirements for HIPAA, the recently enacted Genetic Information Nondiscrimination Act, and the Americans with Disabilities Act, as well as other legal requirements to watch out for in designing a wellness program. (An ERIC bulletin was sent recently that included Moore's outline of the legal issues.)

James Murray, Executive Director of US Outcomes Research for Merck & Co. discussed the case for evidence-based medicine and comparative effectiveness. Murray said that, while evidence comparing the effectiveness of alternative treatments needs to be enhanced even as published studies have grown substantially, the lack of a good evidence-base creates significant variation patterns in use, outcomes, and costs. The benefits of comparative effectiveness, Murray said, would translate into improved consistency, outcomes and productivity, and cost savings to employers of nearly $100 billion over a 10-year period.

Health Care Reform Proposals

Paul Thewissen, Counselor of the Health, Welfare and Sport Department with the Royal Netherlands Embassy, Matt Canedy, Executive Director of the Bipartisan Policy Center's New Leadership State of American Health Care Project, and Tom Miller, a resident fellow of the American Enterprise Institute were the featured luncheon speakers.

Thewissen discussed the health reform efforts in the Netherlands, which moved from a government-run system to a quasi-private system in which employers have a role. He explained the workings of the Dutch health insurance system -- which is being looked at as a model for some U.S. proposals for reform. Thewissen explained the Netherlands' system's individual mandate and requirements for employer contributions to an employee's health plan, regardless of whether the employee participates in the employer plan. He added that most people chose a plan offered by their employer.

Matt Canedy discussed the new health care initiative at the Bipartisan Policy Center organized by former Senate Majority Leaders Howard Baker (R-TN), Tom Daschle (D-SD), Robert Dole (R-KS), and George Mitchell (D-ME). Canedy said the group is holding policy forums around the country with the goal of offering policy recommendations to release after the elections. Tom Miller discussed the prospects for health care reform, and compared the proposals offered by presidential candidates Senators John McCain (R-AZ) and Barack Obama (D-IL). Miller warned against taking on too much, too soon, and suggested incremental recommendations.

Compliance with New Legislation

Kate Berry, Senior Vice President of Business Development with SureScripts moderated a panel that featured Bruce Pyenson, a consulting actuary with Milliman, and Nandan Kenkeremath, former counsel with the House Energy & Commerce Committee. Berry discussed key health IT policy issues and offered a series of talking points for employers to encourage e-prescribing to better manage healthcare costs and reduce variability in quality and outcomes. Kenkeremath discussed new and potential mandates from Congress, including the pending mental health parity legislation, and the recently enacted Genetic Information Nondiscrimination Act. Pyenson discussed why he believes behavioral health parity is inevitable, and how evidence based medicine pays for what works.

Cutting Edge Strategies in Employee Benefits

The final panel featured Scott Macey of Aon Consulting moderating a panel with George O'Donnell of Aon and David Brooker, Vice President for Prudential's Advanced Markets. Both O'Donnell and Brooker reviewed how captive insurance entities work, particularly as a vehicle for providing some employee benefit programs, as well as the growing partnership between risk management and human resources. They discussed what captives insurance entities are, why companies have captives, and the mechanics of an employee benefit captive transaction. Macey discussed how the role of the employer is changing when it comes to retiree health, and provided an overview of the UAW VEBA retiree health agreement as an alternative for companies to consider.

Health Policy Conference Meeting Materials

The links below include the presentation materials of the speakers, and other background information.

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