Will the Delivery of Healthcare Insurance Ever Change?

Innovation Unleashed Podcast

More than 10 years after the Affordable Care Act (ACA) was implemented, healthcare reform still remains a top concern for the United States. For all of these past ten years, and even before, we have discussed and tried to fix the US health system to drive better access, increase affordability, and ensure equity. Yet:

• The number of uninsured Americans is rising. After reaching rock bottom of 28.7 million (8.9 percent of the population) in 2016, the number of uninsured people is expected to rise to 37.2 million (10.6 percent of the population) by 2028. This comes at a time when a growing body of research links insurance coverage to improvements in financial security, health, and longevity.
• Affordability—at both the health system and individual levels—is continuing to erode. Healthcare spending growth initially slowed after implementation of the ACA, but it has accelerated once again. The consequences of this acceleration are well established and include a growing national debt; strained federal, state, and local budgets; stagnant wages; and increased financial insecurity for Americans. Even for those with insurance coverage, health care is increasingly unaffordable: Roughly half of US adults have delayed or avoided care because of cost.
• And the numerous ways implicit bias, racism and prejudice drive objectionable inequalities in health and wellness are increasingly obvious. There remain unacceptable inequities in health care access and outcomes by race, ethnicity, socioeconomic status, and other dimensions. This has been made painfully obvious during the COVID-19 pandemic, which has taken an unacceptably high and disparate toll on underserved communities and people of color.

The COVID 19 pandemic has only made things worse and more evident. Achieving any meaningful change now, in the middle of this global healthcare crisis, seems unlikely. Conversations about changes like expanded insurance coverage, accelerating a US transition to value-based care, advancing home-based care, improving the affordability of drugs and other therapeutics…….leave us all confused and overwhelmed.

The guest on this episode, Jessica Brooks, can help us better understand what change is possible. She is an expert on these topics and the discussion around healthcare value, access and quality on behalf of employer-sponsored health insurance. Employer-sponsored health insurance affects about 156,199,800 Americans, or around 49% of the country's total population get their health insurance from their employer. Jessica is the President & Chief Executive Officer of the Pittsburgh Business Group on Health (PBGH). Under her leadership, PBGH has delivered more than $25 million in annual savings to employers, as well as intervention programs, which have saved employees more than six million dollars in copays and out of pocket expenses since its launch. Ms. Brooks leads the deployment of a comprehensive data strategy, which enables employers to better leverage healthcare and benefits information with health plans, providers and other partners. In many ways this data strategy informed the development of a roadmap as Covid-19 unfolded, allowing for insights on mental health, chronic condition management, COVID-19 cases and utilization insights that drove strategic engagement prioritization for employers.

She also created a transformative health equity tool, Health Desk, a platform of technology and human compassion – developed to bring patients, employers, hospitals, human resources, and patient advocates together to address bias and its impact on the patient experience.