Managed Healthcare Executive - October 2008 - (Page 14)

Industry 2009 State of the REFORM age to more individuals, few have faced the reality of cost constraints that accompany that expansion, including e orts to pay for quality and not volume. Expanding coverage is certainly something that Commonwealth Health Insurance Connector Authority in Massachusetts knows about. “With critical support from the federal government, we’re showing it can be done,” says Jon Kingsdale, executive director of the Connector. “Lessons learned are priceless. Look closely at the data, not just the headlines. Look locally, look nationally and look internationally. There is much out there to be both emulated and avoided.” According to Kingsdale, there are nearly 440,000 newly enrolled bene ciaries since reform was implemented in July 2006. A recent annual survey by the U.S. Census Bureau reports that Massachusetts had the lowest rate of uninsured in the country at 7.9% for the two-year period between 2006 and 2007. But, whatever path managed care executives decide to take, Peter Kongstvedt, an independent advisor based in McLean, Va., suggests being as proactive as possible, preferably in concert with other forward-thinking organizations. “Being reactive always means that somebody else is setting the agenda, proposing the rules, setting the goals,” Kongstvedt says. “Being proactive doesn’t guarantee success, but it at least means that your own goals and objectives will be in the mix early on. “Having said that, proactive absolutely must not look like an exercise in sel sh protectionism—which means understanding the legitimate needs and goals of others, and translating your own goals and objectives into terms meaningful to others,” he concludes. MHE We asked readers to forecast the industry outlook for 2009. Here is what you had to say. W HILE IT APPEARS as if healthcare has taken a back seat to current economic and global issues, 25.9% of nearly 500 MHE readers surveyed see health plans as being the agents of change in its reform. “This indicates a con dence in their own ability to change, as well as skepticism about government’s ability to drive reforms e ectively in a contentious environment. If there is a surprise, it is that [25.9%] is not higher,” says Je Munn, design and development group leader in the health management consulting practice of Hewitt Associates. “Momentum issues get attention, and, assuming that there are solutions that the executives feel strongly about, gaining grassroots awareness and support for those issues will be critical no matter who wins the White House,” Munn continues. Susan Foote, JD, professor, division of health policy and management, School of Public Health, University of Minnesota, Minneapolis, agrees. “Most interest groups—including the stakeholders [listed]—have drafted plans of their own, and are no doubt gearing up to lobby if the issue emerges in the new president’s priority list,” she says. The outcome of the upcoming election could play a role in why almost 23% of managed care executives surveyed by MHE say that they aren’t certain which stakeholder will make the most progress on health reform. Foote goes on to say that while most health plans support expansion of coverOCTOBER 2008 Stakeholders Predicted to Make Most Progress on Health Reform in 2009 25.9% 22.8% 16.6% 16.2% 10.6% 8.0% Health Plans Not Sure Federal State Governments Government Consumer Advocacy Groups Providers Source: Managed Healthcare Executive Reader Survey, 2008 14

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Managed Healthcare Executive - October 2008 For Your Benefit Editorial Advisors Contents News Analysis State Report Politics &�Policy Healthcare Reform Trends in 2009 Cost Control Strategies Predicted Premium Increase Top Challenges in 2009 IT System Integration Technology Innovation Disease Management Health Management Pharmacy Best Practices Technology Desktop Resource Ad/Edit Index Managed Care Outlook Statement of Ownership

Managed Healthcare Executive - October 2008

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