In the latest installment of the Health Affairs Conversations podcast series, Arnold Milstein discusses important aspects of the California health policy landscape. Milstein, a Professor of Medicine at Stanford University and Medical Director of the Pacific Business Group on Health, discusses four “perturbations” in the California health care market:
- increased transparency, specifically at the level of the health care provider;
- experiments in patient incentives—that go beyond incentives to choose less expensive plans or medications—in the form of narrow and tiered networks and reference pricing;
- private accountable care initiatives led notably by Anthem and Blue Shield plans, reinforced by the Medicare Accountable Care Organization (ACO) program and California’s traditional robust managed care market; and,
- provider consolidation, propelled by hospital acquisition of or close affiliation with physician groups.
Milstein discusses these trends and the way they are playing out in California. He addresses questions such as: How much of the cost and quality benefits from delivery and payment system innovations is going to payers and consumers, and what factors stand in the way of consumers fully benefitting from these changes? Can narrow networks offer consumers adequate access and quality, and what dangers must policymakers guard against with respect to these networks?
Milstein also discusses what the future might hold for employer-sponsored insurance in California and what factors—such as the fate of the Affordable Care Act’s “Cadillac Tax”—employers are thinking about as they ponder that future. And building on his work in Health Affairs, Milstein describes pioneering strategies to improve health and health care and to address social determinants of health.
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