Looking Ahead: Paving the Way for a Better System of Health

Looking Ahead: Paving the Way for a Better System of Health

As we begin this new year, I’m reflecting on the state of our health care system. We are on the cusp of an amazing era in health care. Artificial intelligence, genomics, precision medicine and other emerging technologies are pushing the industry toward medical breakthroughs that felt like science fiction only a few years ago. Yet there are so many pressing questions. Will these innovations make health care even more expensive? Will they make care inaccessible and widen already unconscionable inequities? Will they heal the mind as well as the body???

These are questions we, as a society, need to answer. And they are questions the Blues are working hard to address.?

Making Health Care More Affordable?

In 2023, the average cost of employer-provided health insurance for family coverage was more than $23,000. That’s one-third of an average family’s household income. What’s more, that cost has grown so quickly, it's nearly three times higher than in 2001. If we don’t find a way to slow the growth of health care costs in America, more people won’t be able to afford health insurance, or any kind of health care at all.??

This is a fundamental issue, and we believe we can solve it in partnership with policymakers and other stakeholders. The Blues are advocating for commonsense solutions that will deliver real impact by reducing health care costs by $767 billion over 10 years:?

  • Improving competition?among health care providers?while also protecting patients by ensuring they’re not being overcharged for a medical service delivered in a hospital—when that exact same service would cost two to three times less in a doctor’s office.?
  • Increasing access to lower-cost, equally effective prescription drugs by asking Congress to make it easier for patients to have access to generic and biosimilar medicines—which cost less and are just as effective and safe as brand-name drugs. The Blues are also taking action, partnering with Civica and launching Synergie Medication Collective to bring lower-cost drugs to market.?
  • Ensuring patients receive the highest-quality health care at the right place and the right time by transitioning away from fee-for-service payment models to ones that reward and reimburse providers for delivering safe, high-quality care and by promoting telehealth, data exchange and interoperability.??

Building a More Equitable System of Health?

Time and time again, studies have shown unconscionable racial and ethnic health disparities in America. These disparities span education levels, socioeconomic status, age and geography—pointing to deeper-seated issues like underlying chronic conditions, racial inequities and bias within the health care system that must be addressed systemically. There are far too many examples, but here are just a few:???

While the reasons for these disparities are complex, the implications are clear: We must do better. That’s why the Blues continue to prioritize our National Health Equity Strategy to help ensure every American has access to high-quality, equitable care. Through this work we are focused on reducing disparities in maternal health by taking action:???

  • Approach to Care. We continue to call for 10 commonsense actions by providers, insurers, policymakers and private sector organizations , such as adding nurse-midwives and birthing centers to provider networks and unconscious bias training for everyone in the maternal care continuum.??
  • Public Policy. We advocate for policies focused on delivering equitable care, like the Momnibus package and extending Medicaid postpartum coverage from 60 days to 12 months—which can positively impact the 43% of all U.S. births covered through Medicaid.??
  • Data Collection. We are using claims data to identify trends and root causes of disparities and spotlight best practices in maternal health. And we have created a coalition with 18 partner organizations to advocate for standardized race, ethnicity, language, sexual orientation and gender identity data collection, so we can help improve outcomes for everyone.?
  • Communities. The Blues partner with community organizations to address the social determinants of health that are so critical to making new motherhood safe and healthy.??

Filling in the Gaps in Youth Mental Health?

Since 2011, mental health-related visits to emergency rooms by young people have soared, and suicide-related visits to ERs have risen five-fold. Adolescents reporting major depression are up by more than 60 percent. More and more teenagers are being treated for anxiety, mood disorders and self-harm.??

The Blues have 250 initiatives across the country that are expanding mental health support for five million young people. We’re trying to meet young people where they are—and where they need us. Last year, we announced a four-year partnership with the Boys & Girls Clubs of America that will train 48,000 staff members at 5,200 clubs to be trauma-informed to better support the emotional and mental well-being of over 3.6 million children.?

Overall, tackling the youth mental health crisis requires a concerted effort from many stakeholders, including parents, schools, policymakers and community groups. Blue Cross and Blue Shield companies are committed to being part of the solution, to support children and teens as they grow into adulthood.??

The Future of Health Care?

There is so much complexity in the health care system, and, too often, a lack of willingness to overcome differences and make compromises. But from listening to the 118 million people we serve across the country and the 2 million providers we work with, I believe there is a powerful desire to make health care better.??

The challenges I have mentioned, from spiraling health care costs to racial inequities to the lack of mental health resources, are difficult to solve. But we must solve them.??

I believe we can answer the open questions in front of us and create a future where health care is more affordable, accessible and equitable for everyone, and where we focus on both our minds and our bodies. I look forward to the work and progress we will make together in 2024. By taking action, we can—and will—create a better system of health for all.???

This is a powerful message, Kim! Really appreciate you tackling the big issues in healthcare - affordability, equity, and mental health ??

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TRACY LEHR

REPORTER/ANCHOR/MMJ KEYT/KCOY/FOX11

8 个月

If you are covered under UC SHIP as well as a spouse's or parent's health plan, when seeking care "off campus", your spouse's or parent's plan is the primary carrier and UC SHIP is the secondary carrier - except when you're also covered by Medi-Cal, MRMIP, or TRICARE. The primary carrier's benefits are applied to the claim first. The unpaid balance is usually paid by the secondary plan, to the limit of its responsibility. UC SHIP

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Jim Gubler

Physical Therapist

9 个月

Hi Kim! I love your vision for 2024 of finding ways to lower costs and improve outcomes. Would you be open to hearing how Spine PT can save BCBSA millions annually while also improving outcomes and patient satisfaction? I would love to speak you for 10 min to share how Spine PT is revolutionizing physical therapy treatments of the spine and saving insurance providers from paying for expensive, unnecessary fusions. We are getting people with severe discs pain better in 4-6 visits and back to work and living their life pain free. Patients are canceling their surgeries after going through our program. If you can just give me 10 minutes of your time, I believe you will be very interested in what I have to say.

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Megan Marie Young

UM Manager Healthcare Technology at Med-Rok Systems Inc.

10 个月

I love your passion and purpose in the vision for future of healthcare. That is why it is vital to surround yourself with the right tools and allies. I want to talk to you about our answer to a solution for some of your bullet points mentioned in your article. Change is what everyone wants and change is what Transpedite can offer and we can revolutionize the healthcare industry together. I would love a moment of your time. Motivating article and I look forward to having some time to connect.

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Richard Freeman

Insurance Broker, independent contractor

10 个月

Bravo, Kim Keck, for your well written analysis. Glad to see thoughtful people such as yourself helping to describe and take charge in our at times confusing health care system.

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