At a "satellite" briefing held during the Republican National Convention, the CEO of the Cleveland Clinic CEO says the nation needs to learn to live with healthcare reform; Rep. Tom Price, MD, (R, GA) says 'no way.' From MedPage Today.
This article first appeared July 22, 2016 on MedPage Today .
by Shannon Firth
"We have to figure out how we can provide high quality care, better quality care, make it accessible and make it affordable ... that's an enormous job," said Delos "Toby" Cosgrove, MD, CEO of the Cleveland Clinic, at a Thursday breakfast briefing hosted by the Washington Post.
The briefing was one of several "satellite" events held here during the Republican National Convention.
"You have to make [providers] understand what the objective is and figure out how we all get there together," Cosgrove continued.
He said promoting wellness, specifically targeting risk factors like smoking and obesity, was critical to getting a handle on healthcare costs.
The Clinic, which is Cleveland's largest employer and the second largest employer in Ohio -- Walmart is number one -- has been very aggressive in its efforts to promote wellness among its employees. "[W]e don't hire smokers anymore," he said. The clinic also removed all sugar-sweetened beverages from its soda machines.
Also, employees are given specific wellness goals. Employees who meet the goals are rewarded with discounted insurance premiums.
Cosgrove addressed those incentives, or carrots, at a separate panel briefing earlier in the week.
"[W]e started giving [employees] a small financial benefit on their insurance for dealing with diabetes, hypertension, asthma, and hypercholesterolemia. We've seen our inflation rate in healthcare per-member-per-month going from 7.5%, to now going flat and starting down, and that's over the course of a decade."
As an organization, "we've [collectively] lost over 500,000 pounds ... So at the end of the day, you're getting lower costs for everybody, and better care."
Another aspect of the clinic's cost-cutting approach is its focus on innovation, relying on virtual visits, for things such as dermatological appointments -- "you send them a picture of your rash and they'll tell you what the problem is -- and "shared medical appointments" in specific instances, such as giving instructions on how to take diabetes medications.
"[Patients] like it a lot and it's obviously efficient for the doc," he said
Cosgrove does not anticipate the repeal of Obamacare, he expects "continuing modifications."
"It's going to evolve over time ... it's change, and change requires time and discussion and explanation and effort."
Rep. Tom Price, MD, (R-Georgia) said he does believe Obamacare will be repealed.
"One out of every four individuals believe they've been harmed by the current law," said Price who spoke on a separate panel at the same briefing.
Donald Trump understands the "regulatory oppression" imposed by Obamacare, Price told MedPage Today.
Asked whether he believed providers should employ cost-saving strategies such as shared medical appointments, Price was dubious. "[T]o force patients into a mode of treatment that the patient doesn't desire is wrong. And that's what the administration doesn't appreciate."
"I think the first thing [Trump] would do would be to address the regulatory overreach of the federal government in the area of healthcare."
"A lot of individuals get coverage ... but no care," because of narrowed networks and high deductibles, Price said.
Quality has also suffered. Doctors aren't allowed to offer the tests they think are needed or to keep patients in the hospital for the length of time they think is necessary, or choose the best setting for a patient's care, he added.
"All the things that ought to be decisions between patients and family and doctors are being made by the federal government."
Price said he believes in the "repeal and replace" approach and supports Speaker Paul Ryan's "patient-centered" alternative plan.