Paul Ginsburg is the President of the Center for Studying Health Systems Change. The Center is a nonpartisan research organization with significant funding from the Robert Wood Johnson Foundation. The Center is known for a longitudinal study called the Community Tracking Study, which conducts national surveys of households, physicians, and employers in addition to biennial site visits to 12 communities.
Below are links to Paul’s presentation and then the interview in 2 formats:
Paul’s presentation (PDF)
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Another terrific day at the National Consumer Driven Healthcare summit in DC.
Today really seemed to bring home why CDHP appears to have stalled: it is neither for nor by consumers.
Dan Spirek from Trizetto got it right when he said “Consumers didn’t ask for consumer-driven healthcare. No one wants more financial risk”. Again we heard that consumerism isn’t about CDHP nor is it about those who are really sick and driving high cost. For consumerism to be truly effective, it needs to engage all of us in the process of choice and accountability in healthcare– and this is likely to start with ambulatory care and with significant support of the physician community. We had a more extended conversation with Dan that will be posted later.
Sara Collins from Commonwealth Fund went through quite a bit of survey data highlighting how badly CDHP performs–I found a number of their conclusions misleading, as perception doesn’t equal reality, and I didn’t find a number of the selected metrics particularly useful (I’m picky about my metrics)
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Terrific first day at the National Consumer Driven Healthcare Summit here in DC.
I attended 2 different sessions today, a mini-conference on Convenient Care (retail clinics) and the opening day of the full Consumer Driven Healthcare Summit
The moods were very different.
The Convenient Care Association had a small, but very enthusiastic group. Growth projections are enormous—from an estimated 500 or so retail clinics today to somewhere around 5-6000 clinics in the next 5 years. The conversation was around emerging business models in what appeared to be less of a Wild West than such growth expectations would lead you to expect—the atmosphere here was collaborative and determined, as the industry prepares to proactively address concerns on the part of physicians and insurers, heading off an escalation of regulatory and other challenges. We’ll have an update post on this session in subsequent posts.
The broader conference had a mood that was a bit more somber—it was clear that the first wave of CDHP had passed and wide-eyed enthusiasm about the plans and their impact has clearly been replaced by operational and policy concerns about how to bring consumerism into the broader healthcare system. Keynote speakers Jamie Robinson and Paul Ginsberg (interview will be posted soon) made it very clear that the initial wave of CDHP had passed and that the financial-only plans were not going to accomplish what early enthusiasts had claimed. To date, there has been about 5% penetration of the plans, and this has been accompanied by significant policy and consumer concerns around their ultimate impact.
What is more clear is that consumerism as a movement is here to stay, and that it is slowly permeating the broader health insurance/ payment industry. It is also clear that the movement to date has not yet reached sufficient mass to have moved the provider industry—and the provider industry is proving able to change practice approaches in response to incentives—but we have not yet changed the incentives to align provider incentives with desired provider practices. If consumerism is to succeed–and the winds of change are pushing for it– engagement of the consumer and the provider community with real incentives for appropriate change will need to be tied in seamlessly to the payment mechanisms.
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