5 Key Highlights From the AcademyHealth National Health Policy Conference

With the who’s who from the world of health services and policy research in attendance, the National Health Policy Conference hosted by AcademyHealth, January 30-31, 2017, in Washington, DC, delivered on its promise of insightful discussions on the current and future trends within healthcare. The goals of the meeting were best described by Lisa Simpson, MB, BCh, MPH, FAAP, president and CEO of AcademyHealth, as she inaugurated the meeting: “Evidence serves as an anchor in VUCA [volatility, uncertainty, complexity, and ambiguity] times and should help policy makers achieve the goals of healthcare.”

Following are highlights from some of the key presentations and discussions at the meeting.

1. Republican options for ACA replacement.

Senator Bill Cassidy, R-Louisiana, gave the audience a quick rundown on potential replacements for the Affordable Care Act (ACA) and the options that the Republican administration is considering. “A recurring theme on the campaign trail was people saying care was forced on them that they did not need,” Cassidy told the audience. “So we decided to address that and realized that we need an integration of process, policy, and payment,” he said.

2. The optimism of Senator Kaine.

Senator Tim Kaine, D-Virginia, was surprisingly optimistic about the future of healthcare reform in the United States. During a plenary session at the meeting, Kaine said, “The idea of repeal and replace later is like ‘jump off of a cliff and figure out how to land when you’re in mid-air.’” Describing healthcare coverage as peace of mind, he explained that people should have it when they get sick and it should be available even when they are healthy. “You can call it a replacement; we’ll call it a reform, or a repair or an improvement,” Kaine said.

3. Drug pricing and value-based care

Drug price discussions have been growing increasingly intense, especially with a recent spike of innovative drugs that are very expensive. A panel discussion at the meeting dived into the complexity of drug pricing and searched for options to tackle the issue.

Mark B. McClellan, MD, PhD, director of the Robert J. Margolis Center for Health Policy at Duke University, pointed out that each different class of drugs has its own issues, based on whether they are oral drugs, administered intravenously, whether they are generic, or biosimilar. He explained that evidence can inform formulary placement decisions and indication-based pricing, and outcomes-based payments can shift accountability of results to manufacturers as they bring real-world evidence into perspective.

4. A radical idea—stop the pilots; “just do it.”

During a panel on alternative payment models, panelists considered the ramifications of implementing payment models without running pilots. Gail Wilensky, PhD, economics fellow at Project HOPE, said that while mandatory implementation would solve the problem of self-selection, there’s been a long enough learning phase that now it’s time to eliminate experiments with payment reform. Michael E. Chernew, PhD, professor of Health Care Policy, Harvard Medical School, and co-editor-in-chief of The American Journal of Managed Care^®, said that mandating payment models would give the designers more flexibility and would have favorable fiscal ramifications.

5. Nancy Pelosi’s belief in health policy researchers.

House Democratic Leader Nancy Pelosi was a last-minute addition to the meeting, and she had a lot of praise for former President Barack Obama and the successes of the ACA, particularly, including coverage for those under age 26 on their parents’ plan and no penalty for preexisting conditions.

“The idea behind the ACA was to reduce cost and to improve access and quality,” Pelosi said. "We are asking our Republican colleagues to use the CBO [Congressional Budget Office] report, which states that repealing the ACA would result in 18 million losing coverage in 2 years, and up to 32 million by 2020."

She ended her speech by urging the experts gathered at the meeting to share their knowledge and continually provide feedback to healthcare policy makers.