AHIP and the Transforming Provider-Patient Landscape

The impacts the Affordable Care Act (ACA) will have on healthcare delivery will reach far beyond the clinical level. For that reason, America’s Health Insurance Plans (AHIP), a strategic partner of The American Journal of Managed Care, knows that cultivating collaborative discussions about health law implementation is only common sense. For AHIP, education about the ACA must include all stakeholders in the healthcare industry. In fact, at AHIP’s Institute 2013, “Transforming Our Health Care System: Navigating and Succeeding in the New Marketplace,” it came as little surprise that the focus was not only on the physician perspective in healthcare reform, but the consumer experience. As patients increasingly become involved with making their own healthcare decisions, providers will need to think differently about their everyday business practices.

Shared accountability in healthcare requires that patients not only be well-informed, but be continually engaged with their care providers. Consumers must be familiar with the importance of managing their own health and recognizing health risks, so they can improve treatment outcomes. The future of value-based care weighs heavily on patient participation, but they require the proper tools and guidance of trained professionals who can assist them in making effective heathcare choices.

In a recent press release, Karen Ignagni, AHIP President and CEO, discussed several approaches health plans like AHIP are using to control healthcare costs for consumers. The AHIP Board of Directors suggests 3 strategies for reducing such healthcare costs, including: tackling barriers to transparency, facilitating benefit modernization, and advancing bold, structural reforms. Ms Ignagni elaborates on these strategies in The American Journal of Managed Care’s article, “Health Plan Innovations in Delivery System Reforms”:

Making the healthcare system more affordable will determine whether employers can continue to provide coverage, whether individuals can purchase it, and whether important public programs can be sustained. Health plans are playing a vital role in reducing the cost of care and improving value by changing how they pay providers. At the same time, they are creating new benefit designs to encourage patients to choose high-performing clinicians and hospitals and take advantage of care coordination and case management for chronic conditions.

Dr Jan Berger, chief medical officer at Silverlink Communications, also remarked on the changing provider-patient landscape. Dr Berger, who attended the AHIP Institute 2013, said health providers should prepare to become very accustomed to communicating more directly with the consumer. In a recent interview, Dr Berger quipped, “We in healthcare should all hum a few bars from 'The King and I' with the song 'Getting to Know You.'”

Several insurance companies have already began to embrace the change to a consumer-based market, offering technology that transparently allows patients to compare provider rates for various procedures. It truly reflects AHIP’s recommendation for increasing transparency to control consumer healthcare costs. As health plans redesign benefit packages to complement ACA payment reform, and incentivize providers as well as individuals to seek value-based care, stakeholders will be able to increasingly embrace other strategies that will reduce healthcare spending nationally.

For more information on AHIP’s efforts, please watch this exclusive AJMCTV interview with CEO Karen Ignagni: Karen Ignagni Discusses the Value of AHIP's Strategic Partnership with AJMC

Around the Web

Transforming Our Health Care System: Navigating and Succeeding in the New Marketplace [AHIP]

AHIP Board of Directors Outlines Strategies for Reducing Health Care Costs, Implementing Payment Innovations [AHIP]

Health Plan Innovations in Delivery System Reforms [AJMC]

Insurers preparing to market to consumers as coverage expansion nears [Modern Healthcare]