Business of Health Care Conference Focuses on Policies, Technology and People

Health care leaders addressed pivotal questions about “Medicare for All,” the Affordable Care Act, health care delivery in the Americas, and disruptive technologies at the Miami Business School’s eighth annual Business of Health Care conference, “Technology & People, U.S. & Beyond,” on March 29 at the Watsco Center.

The heads of six leading health care providers, insurance, and business organizations agreed that neither “Medicare for All,” defined as a single-payer system, nor the dismantling of the Affordable Care Act (ACA) are the best approaches to address health care access and affordability.

The recent move by the U.S. Justice Department not to defend the ACA in the courts creates greater instability within the health care system that could drive up premiums and other costs, panelists said. Instead, they agreed that lawmakers and the industry should focus on fixing the ACA and providing universal health care coverage.

“We should be talking about universal coverage, rather than relying only on the federal government for reimbursement,” said Maryjane A. Wurth, executive vice president and COO of the American Hospital Association. “Let’s strengthen what we have – the Affordable Care Act – and move on."

From U.S. health policy to investment opportunities to delivering care to underserved populations in the Americas, technology has a growing impact on stakeholders throughout this global sector.  “No issue today is more important than health care,” said University of Miami President Julio Frenk, M.D. “Every year, this conference allows UM to bring business leaders, physicians, students and policymakers, together to share their perspectives.”

John Quelch, vice provost, University of Miami and dean, Miami Business School, welcomed more than 900 health care executives, physicians, consultants, and students to the sold-out event, whose sponsors included Florida Blue, Boston Scientific and Vitas Healthcare.

“Every year our conference attracts outstanding leaders, regionally, nationally and internationally,” Quelch said, noting that the school is celebrating the 40th anniversary of its health care executive MBA program, which was recently ranked #1 in the nation by U.S. News & World Report.

This year’s conference was the largest ever, according to Steven G. Ullmann, chair and professor, Health Management and Policy, and director, Center for Health Sector Management and Policy.  “With policymakers in Washington turning their attention to health care policy, this was certainly a timely conference, and produced consensus around some critical questions of our time,” he said. “We deeply appreciate the support from our speakers, sponsors and attendees.”

Both professional and student attendees gave high marks to the conference. “It was very valuable in addressing the issues relating to U.S. health care policy, physicians’ practices and consumer trends,” said Gema Milanes, a broker with AON insurance.  Bethany Franz, a graduate student in the school’s Master of Health Administration program, said importance of social determinants on the overall health of the country was another key point from the conference.


Technology and Providers
Technology’s impact on providers was front and center in the morning keynote panel, “Health Care Innovation – Technology & People, U.S. & Beyond,” moderated by Patrick J. Geraghty, president and CEO, GuideWell and Florida Blue. “One of the challenges facing our health care system is integrating the various points of view,” said Geraghty. “This panel provides a unique opportunity to hear from the key leaders all at one time.”

Costly investments in electronic medical record (EMR) platforms are adding to providers’ burdens, according to panelists Matt Eyles, president and CEO, America's Health Insurance Plans; Joseph Fifer, president and CEO, Healthcare Financial Management Association; Halee Fischer-Wright, M.D., president and CEO, Medical Group Management Association; Ernest Grant, president, American Nurses Association; Barbara L. McAneny, M.D., president, American Medical Association; and Wurth.

“Physicians love technology that works, like cell phones, scanners and robots,” said McAneny. “But the EMR is a filing cabinet hooked to a typewriter for one patient at a time. We would love to have an EMR that helps us in taking care of patients.”

Grant noted that mobile applications can play a critical role as health care transitions to community setting. “We may be able educate patients with conditions like diabetes or high blood pressure, and address the underlying social determinants of health.”

Calling this the “best and worst of times in technology,” Eyles said the U.S. health care system is on the cusp of transformative changes as the sector moves past legacy systems to new platforms that can provide real-time information on patient care, cost and quality.  “We are at an awkward stage, as investments have been made, but the returns haven’t come in yet.”
 

Health Care in the Americas
Latin America and the Caribbean face both the health care challenges of advanced economies, as well impoverished communities, said Frenk, who moderated a panel discussion on “The Role of Government in Health Care Around the World” with three of the region’s ministers of health.  “Technology is a key potential driver of positive transformation, but you need to have everything around, including the right people and the ethical context,” he said.

Juan Pablo Uribe Restrepo, M.D., Colombia’s minister of health, said providing universal coverage under a multiple payer structure has been successful in reaching 97 percent of the country’ 50 million people. “Our challenges include delivering quality care, addressing vector-borne diseases and training nurses and other skilled professionals,” he said. “We are also investing in data analytics to predict patterns of certain diseases.”

Christopher Tufton, M.D., minister of health for Jamaica, said the 2.8 million nation faces similar challenges. “We have digitized our main hospital and are establishing a technology platform that will allow patients and health centers to communicate with each other, and support telemedicine.  Citing the “Jamaica Moves” initiative, Tufton said, “We need our citizens to appreciate their own role in protecting their health status.”

Adolfo Luis Rubinstein, M.D., Argentina’s national secretary for health, said chronic diseases account for more than 70 percent of the country’s health burden. “We are spending a lot of money on health care – almost 10 percent of GDP – but our results are not as good as we could expect, particularly in terms of health disparities. We have also found that new technology is more effective in wealthier populations than poorer ones.”


The Future of Health Care
In his keynote talk, “The Future of Health Care: From the Flintstones to the Jetsons,” medical futurist Rubin Pillay, M.D., Ph.D., looked at how mobile and digital technology is advancing the “prosumerism” of health care, as well as offering new tools for providers. “Today, we have Flintstone business and operating models wrapped around Jetson-era technologies,” said Pillay, professor of healthcare and entrepreneurship and assistant dean for global health innovation at the University of Alabama School of Medicine. “Our health care leaders and managers need to look at things differently.”

Pillay pointed to the rapid pace of innovation in smart phones and wearables that allow consumers to monitor their health and perform diagnostic checkups rather than visiting a primary care provider.  Other notable advances include gene editing to prevent disease, 3D printing of corneas for transplants, and exoskeletons that allow paraplegic patients to walk again. “Brain interfacing with computers or robots will be science fiction brought to life,” he added.

Machine learning and artificial intelligence (AI) can help providers overcome their cognitive limitations and make decisions based on sound evidence, Pillay said. However, AI’s ability to draw conclusions based on comparing images will impact specialties like dermatology, radiology and pathologies.

“Technology can lead to better, faster and cheaper diagnoses,” he added. “In some cases, it can make patient care available at a cost approaching zero. It is also democratizing medical knowledge formerly held by providers and insurers.”

Reflecting on technology’s potential, Pillay said, “We have never been better positioned to change the trajectory of health care. “But we have a long journey to get there.”

 

Health Care Systems and Business Innovation
Two afternoon panel sessions looked at how health care systems, businesses and investors are looking at technology. Norma Sue Kenyon, UM vice provost for innovation, and chief innovation officer, Miller School of Medicine, moderated a discussion on “Technology and People in Health Care Systems.”

Edward Abraham, M.D., CEO, UHealth – the University of Miami Health System, kicked off the conversation by noting that the implementation of an “Open Table” approach to patient appointments has improved patient access and the overall experience.

Mobile technology is enhancing the delivery of end-of-life care, said Patrick Hale, EVP and chief information officer, VITAS Healthcare. “We get our clinicians to the bedside as soon as possible, giving them more time to spend with patients and families,” he added. “We are also using video and virtual reality tools to help fulfill a patient’s last wish.”

Ed Martinez, SVP and chief information officer, Nicklaus Children's Health System, said the digitization journey has focused on engaging and informing patients and families. “One of the game-changers for us was digitizing the discharge process, including a ‘doctor’s note’ for children who missed school,” he said.

While technology can help with transitions of care management, caregivers still need to provide education and emotional support, added Brian Holzer, M.D., CEO, Lacuna Health, in Louisville.

The last panel on “Technology, Trade, and the Global Health Care Business Climate” focused on investment trends and was moderated by Richard Clarke, senior fellow and clinical professor, Department of Health Management and Policy.

“Private equity funds are looking for clinical and non-clinical models that will drive higher quality or care or lower costs,” said Aaron Feinberg, vice president, EY-Parthenon. “That might include physician practices using data analytics or empowering nurses to practice at the high end of their licenses.  Investors like companies that are producing cash flows and are scalable today”

Brent McDonald, managing director, Bank of America Merrill Lynch, said investors are more likely to allocate capital to outpatient facilities rather than make significant acquisitions.  “When it comes to technology, hospitals and health systems need venture capital and private equity firms to figure out what’s next, because they can’t experiment with patient care.”

Summing up the session, Clarke said one of the challenges for decision makers is determining the value of technology. As he said, “It can be difficult to determine the return on investment, especially in developing countries with limited resources.”