Data and evidence were front and center at Academy Health’s recent National Health Policy Conference (NHPC). The event included a wide range of perspectives from the 700 attendees. Despite the diversity in the audience of health policymakers, legislators, practitioners, and academics, a common theme was that data and evidence should inform policy debates and decisions. Researchers from the Deloitte Center for Health Solutions joined dozens of other presenters in sharing evidence and examples from practice.
One theme that especially resonated with me is that health care is local. Several sessions highlighted state initiatives to improve the health of communities. These initiatives include adjusting to changes created by the Affordable Care Act (ACA), implementing policy changes, and working to help ensure that local health care markets work as intended. Other initiatives include addressing non-medical determinants of health and combatting the opioid epidemic.
Here’s a look at some of the highlights from this year’s NHPC:
- The ACA’s impact on health plans continues to impact communities: During our session on health care payment and delivery system reform, we described our research on the ACA and financial performance of health plans between 2011 and 2016. The law and related regulations drove change among health plans, and we discussed the importance of well-functioning local insurance markets. Our study shines a light on why many health plans struggled financially, particularly since 2014, as they tried to navigate a disrupted and increasingly competitive market. Health plans that posted underwriting losses tended to be smaller-scale companies, often nonprofits, which may lack the financial resources to endure difficult years. Many of these health plans play critical roles in their local communities and within the health care ecosystem. Their financial prospects warrant continued attention.
- Hospitals are working more closely with their communities: Robert K. Ross, M.D., president and CEO of The California Endowment, provided an overview of work in his state to harness the power of local communities to improve health. He emphasized the importance of non-medical factors (the so-called social determinants of health) in improving health outcomes within a community. Our recent research found that a growing number of hospitals and health systems are considering these factors. They are beginning to work with health plans and their communities to link community and clinical services to help improve health outcomes in the long term.
- The older version of the hospital ratings program had some unexpected winners: The US Centers for Medicare and Medicaid Services (CMS) developed its Star Ratings Program to help consumers compare hospitals by their quality ratings. During a session on improving consumer transparency, we shared results from our recent analysis of the stars program. We found that performance tends to be related to variation in caseloads and the ability to report some measures. Based on CMS’s recent modifications to its ratings methodology, it appears likely that efforts to measure hospital quality will continue. As hospitals look to improve quality and improve their star ratings, they might consider a broad quality improvement strategy. This might require investing in technology and analytics tools that help support goals, and developing and promoting a culture of quality improvement among clinicians.
- Hospital leaders want to improve value: Smarter spending was another theme woven through several sessions. Mandy Cohen, North Carolina’s Health and Human Services secretary asked, “How are we using our dollars to buy health?” This is an issue that is keeping many hospital CEO up at night, according to our research. We found that many CEOs expect to see tighter operating margins due to growing financial pressure from policymakers, industry, and market changes. Other issues, such a rising labor costs, fluctuations in payer mix, and regulatory changes are pushing many hospitals and health systems to reduce costs and increase revenue. We shared our research on this topic. It examines innovative technologies and cost-reduction strategies that hospitals should consider to enhance revenue, increase efficiency, and achieve long-term financial stability.
As a researcher within the Deloitte’s Center for Health Solutions, data and evidence are always at the forefront of our efforts to assess the potential impact of programs and policies. We use data and evidence to stimulate new ideas, address complex health care challenges, and help our clients navigate the ever-changing health care landscape.
As U.S. Surgeon General Jerome Adams noted during the conference, “we can’t help folks understand how health is important to the issues they care about without the data.”