On Tuesday, April 11, the American Cancer Society Cancer Action Network (ACS CAN) held their annual National Forum on the Future of Health Care at the National Press Club in Washington, DC.

ACS CAN’s President opened by stating that our nation’s health care system was at a clear inflection point, and set the tone for the Forum’s focus on health reform: ranging from the continued effects of the Affordable Care Act to recent attempts to modify or eliminate that law’s provisions. A diverse group of speakers and panelists from the academic, payer, provider, manufacturer, and advocacy communities weighed in with their vision of what patients need from a health care system, and the status of progress toward that goal.

The morning’s keynote speaker, Dr. John McDonough of the Harvard T.H. Chan School of Public Health, identified five main trends in recent efforts to reform the Affordable Care Act:

• Repeal of ACA’s central tenets in Title I of the Act
  • E.g. Exchanges, subsidies, essential health benefits, penalties for noncoverage, protections for pre-existing conditions
• Modifications to Medicaid
  • Not just changes to expansion, but structural changes to the funding model
• Repeal of ACA’s tax provisions
  • E.g. high-cost employer coverage, additional social security tax on high-income taxpayers, medical device tax
• Changing the tax treatment of employer-sponsored insurance
  • E.g. replacing the “Cadillac tax”
• Moving Medicare to a premium support model

Dr. McDonough opined that, after the collapse of the AHCA, not only was there no clear pathway for these reforms to continue, but that a support for the existing law was reaching an all-time high, indicating waning public appetite for large-scale modification. Instead, in Dr. McDonough’s opinion, future efforts should focus on the “serious, but manageable” problems with existing health care systems, specifically affordability. He pointed to previous efforts including Medicare Advantage and the Part D prescription drug program, and specifically their reinsurance, risk adjustment, and risk corridor provisions as perfect examples of reforming trouble private markets that are now considered by most to be a tremendous success. Dr. McDonough closed on an optimistic note, that he is beginning to see the emergence of a bipartisan commitment in Washington and across America to making health care affordable and functional for all Americans.

Following Dr. McDonough’s presentation, a panel of health care experts shared their impressions of what patients (and specifically cancer patients) need from a reformed health care system. These panelists included:

• Dr. Andre Baskin, Vice President, National Medical Director for Quality and Clinical Policy, Aetna
• Kathryn Chandra, Senior Manager, Policy & Reimbursement, Genentech
• Dr. Barbara McAneny, Member, Board of Trustees, American Medical Association
• Dr. Randal Weber, University of Texas MD Anderson Cancer Center
• Dr. Tricia Neuman, Senior Vice President and Director of Programs on Medicare Policy, Henry J. Kaiser Family Foundation

Their insights included:

• Patients want to be treated close to home, properly, and without going bankrupt. -Dr. McAneny
• Shifting responsibility back to the states for implementation of health coverage will lead to fragmentation in private insurance markets. – Ms. Chandra
• Research institutions present higher costs by their nature, making affordable patient care an even larger challenge. -Dr. Weber
• Narrow insurance networks can manage costs, but only if they work together as a system. – Dr. Baskin

Reacting to a new ACS CAN report which found that patient out of pocket costs in 2014 for cancer care totaled $4 billion, panelists stated that:

• Controlling costs is a holistic challenge, and must include providers, insurance, drug companies, and others. -Ms. Chandra
• Physicians need help from laboratories to understand who will benefit from (expensive) targeted therapies. -Dr. Weber
• Taking on actuarial risk under new MACRA programs will be a death spiral for most practices. -Dr. McAneny
• Value-based contracts aren’t just a contract, they’re a partnership where payers need to be cognizant of what providers require in order to actually provide the desired value. -Dr. Baskin

An active conversation with members of the audience demonstrated that much work remains to ensure the stability of America’s health care system and that patients have access to the care they need. Applied Policy is grateful to the American Cancer Society Cancer Action Network for bringing together such a distinguished panel to discuss these critical issues. We are excited to discuss how we can help your business navigate the changing health care system and improve the lives of those who need access to treatment. Contact us at gpugh@appliedpolicy.com or 202-558-5272 to start the conversation.