Donald Crane

2015 CA Summit - Fostering Innovation to Improve Health Care

Ross DeVol, Donald Crane, Ed Hernandez, Richard Merkin, Kristen Miranda, Art Torres

Leading health stakeholders convened to address California's critical healthcare challenges, including a bifurcated payment system introduced by the 2015 MACRA law and the accelerating market consolidation among insurers like Blue Shield and Anthem. Panelists highlighted that while innovations such as the Heritage Health Prize and joint data exchanges offer promise, systemic barriers like low Medi-Cal reimbursement rates and a 300% pay disparity between specialists and primary care providers continue to drive costs and exacerbate workforce shortages. The discussion concluded that without shifting from volume-based to value-based models and addressing demographic disparities in Covered California enrollment, unchecked consolidation may force government rate regulation to protect consumers.