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What's next for managed care? CEO roundtable participants debate key issues for insurers and health plans as the reform debate advances.

Article Excerpt
David Burda: Why don't we start off with reaction to President (Barack) Obama's first 100 days in office and your perspectives on his progress or lack of progress on healthcare reform.

Larry Boress: I think frankly he's been very aggressive in a surprising way in healthcare. Clearly we thought that with all the economic issues and the war and other things that there just wouldn't be any money left for healthcare. In fact, at a meeting of our organization in May of last yearwe represent a lot of large, self-funded employersthe question was: How much do you think can be done in healthcare reform 12 months after the election? Virtually no one said there would be any substantial healthcare initiatives, maybe something incremental.

So it's been quite surprising. I think due to the economy, the emphasis of people losing coverage on top of everything else happening has really raised that issue to a much higher priority than we had anticipated, so in light of what's gone on in these first 100 days, it's been surprising.

Burda: Vicky, would you agree with Larry's assessment?

Vicky Gregg: Yes. I think when you look at what's occurred just in the first two months of his administration, much less 100 days, there was tremendous activitySCHIP (the State Children's Health Insurance Program), the expansion of subsidies for COBRA, looking at SGR (the sustainable growth rate) and how they handled that in terms of looking at the deficit. Tremendous steps forward on healthcare.

I think it shows a real commitment on the part of this administration to meaningful healthcare reform. When I try to take a step back and look at what happened just in those weeks, it seemed to me that more occurred in that time frame than perhaps we had seen both in the Bush and maybe even the Clinton administrationsperhaps even combined when you add up the dollars.

Allan Baumgarten: What I'm looking at is what we can learn from the bailout of the financial sector. For example, I think we're obviously seeing a move toward much stricter regulation from the financial sector, and I think that any health reform package coming out of Washington will include additional regulation of provider payments, facilities construction, a whole range of things.

Neil McLaughlin: Is there any particular reform proposal or initiatives that are of particular interest to health insurers and employers?

Boress: I think that we're pleased, we're actually very gratified, that the discussion about reform has moved away from, just, `Let's just cover everyone and we've solved the problem.' Because even if we cover everyone, we have problems of quality and safety, problems of payments not aligning with outcomes and transparency issues.

They're starting to really talk about changing the fundamental elements of the system and really focusing on trying to look for outcomesfocusing beyond just paying for volumeof paying for good performance and good care, trying to identify better performers, providing more information for people. And I think we're trying to really now getit's a long-term solution. HIT (health information technology), all these other things, they're not short-term.

Gregg: I think what we see is really a very deliberate and almost thoughtful approach to healthcare, which is refreshing in many ways. I think as you watch the administration, they're building that sense of urgency in the country. I think tying it, as Larry said, to the economic situation and trying to make sure the people understand what is at stakeboth short-term but as...

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