Karen Ignagni on Health Care Reform

Where Are We Headed Next?

Karen Ignagni, EmblemHealth President and CEO, kicked off the University of Rochester, Simon School of Business’ “Succeeding in the New Health Care Economy” series on February 11, 2016, with an in-depth conversation about the future of health care reform and its impact industrywide.

“Discussing the future of health care reform has to begin with understanding and analyzing the current political arena,” explained Ignagni. Looking ahead to the 2016 election, she predicted that a newly elected Democratic president will ask, “How do we solidify and stabilize the current health care market?” Whereas a Republican president will look to engineer an Affordable Care Act alternative with a renewed focus on tax policy and state leadership.

“Regardless of political direction, the cost of prescription drugs has catapulted onto the national stage, and will be a major issue in the campaign, as well as for the nation, moving forward,” she added. “Pharmaceutical cost transparency is imperative for health plans to deliver affordability to consumers.”

Affordability is a primary consideration and driver for all health care industry stakeholders.Once you empower consumers in shifting from a business-to-business focus to a business-to-consumer model, they are in the driver’s seat and will be looking carefully at costs.” The cost-conscious health care consumer will demand greater transparency in drug spending as well as research and development costs.

Ignagni also addressed the impact of hospital consolidation and the importance of value-based care. She explained, “Hospitals are consolidating at a rapid pace, and with that, costs are increasing.” Redesigning the healthcare ecosystem to reduce costs is needed now more than ever. She also discussed new health plans will partner with hospitals to achieve that goal.

Value-based care is one example of innovation at the payer level to reduce health care costs and champion support for affordable care. The arrangement rewards physicians on providing greater value and care coordination, rather than volume or service duplication. Ignagni emphasized, “Treating patients prospectively instead of body part by body part, and focusing on quality instead of volume positively impacts the health care consumer.” Patients benefit from payment models that encourage active care coordination and advance safe, appropriate and effective health care at an affordable cost.

She closed explaining EmblemHealth’s market position and its affordable care advantages. “We’re a mini-Kaiser uniquely positioned to lead the market in value-based care.” At AdvantageCare Physicians, designated care teams, led by primary care physicians, customize patient experience and ensure consistent, coordinated care regardless of location. “Our relationship with multi-specialty practices like AdvantageCare Physicians allows us to deliver unique care coordination while keeping the patients’ cost front of mind.”

For additional information on the University of Rochester, Simon School of Business’ “Succeeding in the New Health Care Economy” series, please visit simon.rochester.edu.