Reflections on the Latest LHC Delegation to D.C.
Leadership Health Care (LHC) - an initiative of the Nashville Health Care Council for emerging industry leaders - wrapped up the group's annual pilgrimage to Washington, D.C. on March 13.
Now in its 16th year, the trip offers an exclusive opportunity for LHC members to hear directly from members of Congress, administration officials and national thought leaders from the public and private sectors on some of the most pressing topics in healthcare including policy priorities, federal healthcare spending, and reform implementation.
Michaela Poizner, an attorney in the Nashville office of Baker Donelson who works with clients on healthcare transactions and compliance issues, shared her reflections on the 2018 fact-finding and networking event.
NMN: You've been part of this delegation before. How does the program stay fresh and relevant?
Poizner: The delegation does an excellent job of zeroing in on the topics that matter most right now -- and we all know that in healthcare, that can change almost minute by minute. So, while the delegation happens every year, it's never stale. As long as health policy is interesting -- and health policy will always be interesting -- the delegation will be a dynamic forum for the conversation.
NMN: What speaker stood out to you this year and why?
Poizner: The keynote speaker, Chris Stirewalt of Fox News, was one of the more provocative keynotes I've seen at the delegation in recent years. Whether attendees agreed or disagreed with his basic premise -- that government cannot cure what ails us as a country -- there's no denying the room was engaged. Let's just say there was plenty to talk about at the after-dinner cocktail reception.
NMN: Any sense from the experts on where health reform stands and what that might mean for the industry?
Poizner: The collective sense seems to be that the time for repeal and replace may have passed, and the Affordable Care Act may be with us to stay. Going forward, Congress and the Department of Health and Human Services (HHS) will continue to tinker at the margins, as we've already seen with actions related to the individual mandate, cost sharing reduction subsidies, and short-term plans. But it appears that, at least for the foreseeable future, the Affordable Care Act will continue to be the framework we're living under.
NMN: Increasingly, the nation's health system seems to be moving from an acute, episode-of-care model to a more holistic, preventive care model. With that has come more recognition that social determinants impact outcomes. Was there any mention of 'bigger picture' healthcare efforts or coordination across multiple federal disciplines?
Poizner: Several of this year's delegation sessions addressed the role that social determinants play in health outcomes, particularly in rural parts of the country. For example, this theme echoed repeatedly in references to the opioid crisis - which touches not only public health but education, poverty, housing, and many other non-medical factors.
There is certainly a recognition, which came through loud and clear at the delegation, that to attack these big-picture problems, we need coordination beyond HHS and healthcare providers into schools, neighborhoods, police departments and places of worship.
NMN: Any insights on Medicaid or Medicare?
Poizner: Several sessions at the delegation touched on the evolution of the Medicaid program. This is an interesting time for Medicaid, as states get more leeway from HHS to experiment with waivers. We are seeing this play out in the debate about work requirements for beneficiaries, for example, as states wrestle with whether Medicaid should continue to function as an entitlement program or play some other social insurance role.
NMN: What were your biggest take-aways from the 2018 delegation?
Poizner: It seems like every year, there are two or three themes that seem to find their way into multiple presentations. This year, those topics were value-based reimbursement models and the opioid crisis.
We had a panel discussion on the opioid crisis, and the perspectives ranged from lawmakers to industry. But it is clear that there is consensus around the urgency of this issue as a public health emergency. As speakers throughout the delegation - speaking on a wide range of health policy matters - one after another referred to the opioid crisis in their remarks, it was clear that this issue is not far from anyone's mind.
The same was true of value-based payments. Everyone from elected officials to financial analysts to journalists hit on the subject, underscoring its importance in the health policy discussion today.