The U.S. health care system would have to change with or without the Affordable Care Act because it costs too much and produces inadequate results, the chief executive officer of Alegent Creighton Health told an Omaha group Thursday.
The nation two years ago spent $2.7 trillion, or about 18 percent of its Gross Domestic Product, on health care, Richard Hachten said. That far exceeds medical expenditures by most other industrialized nations, he said, and Americans as a whole aren’t comparatively healthy. That, he said, is largely because 40 million or more don’t have health insurance.
Hachten told about 100 members of the Association for Corporate Growth Nebraska that his health care system anticipated change without federal prodding and is engaged in ways to monitor patients so they don’t return to the hospital. It also is preparing for a shift in payments to hospitals and providers, where they increasingly will be reimbursed for qual4ity care and not for the number of procedures done.
“It’s simply not sustainable to us as a nation,” he said of health care expenditures. Those costs are “eating up our resources nationally,” he said.
Hachten said that in a program involving 324 of Alegent Creighton’s own high-risk employees, such as diabetics, educating them, communicating with them after hospitalizations, making sure they took their meds and followed up with their doctors resulted in savings. Health care expenditures on those employees totaled $15.8 million in 2011 and $10.4 million the next year, after the program went into effect, Hachten said.
Hachten said payers — insurers and Medicare/Medicaid — will transition into a system where they pay fixed amounts per patient load. He said that system is fine with him as long as providers, such as Alegent Creighton, share in the savings that accrue from managing patients well.
But if the fee-for-service system lingers, he said, a system that manages patients well puts its own financial health in jeopardy if payers don’t share the savings.
Hachten said after the meeting that he intends to retire at the end of the year or early next year. Hachten became the organization’s president in 1996, left for a time, then returned in 2009 to head the system. He also is a senior vice president with Catholic Health Initiatives, a national health care organization.
Last year, Hachten oversaw Alegent’s acquisition of Creighton University Medical Center and the physicians’ group, Creighton Medical Associates. Alegent Creighton has more than 1,500 physicians and 10,000 employees. The system, sponsored by Catholic Health Initiatives, oversees six metro-area hospitals and five outside the area. It controls 50 percent of Omaha’s health care market, he said.