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Photo: Melissa Kelly

The Arrupe Center Business Leader Series

– Casey McBride ’16

In Fall 2013, the Arrupe Center hosted its first event in The Arrupe Center Business Leaders Series by welcoming Daniel J. Hilferty ’78, President and CEO of Independence Blue Cross, to discuss transforming healthcare through innovation.  The series continued in December with a presentation by Jack Lynch, President and CEO of Main Line Health, on ethical issues in the delivery of healthcare.

As the inaugural speaker for the series, Hilferty discussed the ways Independence Blue Cross was changing its system in order to prepare for the 45 million new people that would be entering the healthcare system as a result of the Affordable Care Act.  The company chose to create an array of 13 different plans so that all people can have some type of coverage.  By hiring new phone representatives and expanding its online media platforms, Independence Blue Cross is trying to reach out to more people so that customers can decide what plan, whether it be from Independence Blue Cross or another provider, is best for them. 

Hilferty wants to bring government, pharmaceutical companies, entrepreneurs, and other institutions together in order to start healthcare innovation in the Philadelphia area, hoping to transform Philadelphia into the Silicon Valley of healthcare.  Hilferty’s goal is to bring the right level of care at the right time in order to decrease the amount of emergency room visits. If emergency room readmissions and the costs of procedures fall, this will save money and will enable costs to remain low for patients in the long term.

“The Affordable Care Act does not address cost itself,” Hilferty states.  “What is really going to impact the cost is where we are all sharing the same data, we have the technology that talks to each other, and we’re using that data to develop care pathways and agreed upon reimbursement levels based on outcomes where we can all begin to drive down costs.  That’s where we’ll see the impact in costs.”

Dr. John McCall, who moderated the discussion, states, “At the Arrupe Center, one of the ideas that we focus on is corporate social responsibility. I think what you’re describing is that Independence Blue Cross is taking the position that its corporate responsibility is to the broader public.  It’s not just the organization you’re focused on; you’re focused on many more constituents than just Independence Blue Cross.”

Lynch took a different approach when addressing healthcare, talking more about the delivery of healthcare itself under the Affordable Care Act than about the insurance plans that have been made available under the Act.  The focus of his discussion was the Act and Main Line Health’s response, stressing the importance of their health system’s strategic initiatives: superior patient experience, highly engaged people, market growth, research, clinical education, and financial performance.

The Affordable Care Act is able to expand the population’s access to coverage and slow health care cost growth, both having an impact on health providers.  In previous years, medicine has been “doing more for more [people] with less and doing it better,” but what Lynch wants to reinforce is that medicine should be doing “less for more [people] with less and doing it better.”  He wants to make sure that each patient is getting the proper care he or she needs.

“Today, we and the doctors get paid more every time we do something to a patient. But the problem, as the changing reimbursement model evolves, is that more is just going to come out of our pocket,” Lynch states.  “So I think the first ethical question is, ‘How do we make sure that the patient gets the care that he/she needs?’  One of the things I’ve told our medical staff is what I want us to be doing is what’s right for the patient.”

In response to the changing healthcare landscape, Main Line Health felt it had to redefine its business as health care, not hospital care, in order to improve patient care overall. Main Line Health had four goals in mind when reassessing their business: safe care, quality care, quality cost per case, and physician alignment. 

As an administrator, Lynch has to make ethical decisions with his colleagues based upon these four aims and the needs of the patients.  “When people need care, we give it to them.  Who should pay for it?  Is the hospital’s obligation to the patient or the community?  We want to use evidence-based care, but who is paying to research these standards?  We need more physicians and nurses.  Who is going to find and provide the training for these individuals?” Lynch asked.

Both Hilferty and Lynch discussed the changing healthcare environment and how to react to the changes that are coming to healthcare insurance and delivery.  Innovation in the healthcare industry is continuous and all health care providers, no matter how big or small, must adjust to the changes.  While both CEOs are making efforts for the healthcare system overall, their focus is ultimately on making a positive difference for their clients and patients.

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