Fireside Chat, Conference Presentation
Tuesday Lunch With Alex Azar, Secretary, US Department of Health and Human Services
- U.S. healthcare spending is projected to maintain a 3.9% growth trajectory following the $3.5 trillion figure recorded in 2017, while inaction on chronic diseases is forecast to incur annual costs exceeding $1 trillion.
- Strategic implementation of a "unified theory of health care" aims to deliver a personalized, patient-centric system focused on affordability, choice, and quality over the coming years.
- Key administrative efforts target financing reform, value-based payment, and specific impact areas including kidney care, opioid crisis mitigation, primary care, maternal mortality, rural health, and social determinants.
- Opioid overdose deaths are expected to continue declining, supported by a 5% reduction in current metrics and a "Healing Communities Initiative" targeting a 40% reduction in deaths across four states within a four-year period.
- The opioid response model, contingent on successful four-state data collection, is planned for potential replication via state grant programs or congressional action, with resulting data designated for open-source public use.
- Kidney care strategies involve incentivizing home-based dialysis and transplant procedures to double available kidneys, alongside new payment models that reward preventing disease progression and investments in "KidneyX" to develop next-generation care delivery methods.
- Significant shifts in kidney care delivery are anticipated within the next decade driven by current NIH and BARDA initiatives.
- A primary care model covering one-quarter of Medicare beneficiaries will transition to "total cost of care" accountability, enabling providers to retain savings while incentivizing investments in social determinants like air conditioning and nutrition to reduce hospitalizations.
- Regulatory streamlining measures are projected to save 40 million hours of clinical staff time between 2019 and 2021.
- Benchmark plan premiums are expected to decrease by 4% in 2020 compared to the previous year, with the addition of 120 new insurers and existing reinsurance pools projected to lower premiums by 10 to 30 percent.
- Commitments include maintaining the Affordable Care Act to maximize choice and low premiums, ensuring 180 million Americans with private insurance experience no disruption to current plans, and protecting coverage for 60 million Medicare beneficiaries while seeking federal funding for Medicaid to avert state insolvency.
- Infrastructure enhancements focusing on transparency, interoperable health IT, and data availability are planned for extension across the 331 million U.S. population.
- Future incentives are designed to align providers toward preventing chronic kidney disease progression and addressing maternal mortality through holistic coordination among OBGYNs, midwives, and primary care providers.
- Behavioral economics approaches are intended to modify long-term health decisions regarding diet, smoking, and e-cigarette use by prioritizing incentive structures over education alone.