By Karen Guzman
Innovation is the key to creating a more equitable, financially sustainable healthcare system, and Connecticut can lead the way, according to an expert panel that convened at the Yale School of Medicine on October 15.
“Healthcare is poised for change, and the state of Connecticut is poised for change,” said panelist Ned Lamont ’80, the Democratic candidate for governor in Connecticut. “We may not see the leadership coming out of Washington, D.C., in the near term… [but] this is a place where we ought to be able to take the lead.”
Suzanne Lagarde ’14, CEO of Fair Haven Community Health Center, and Andrew Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services, joined Lamont as panelists in a discussion sponsored by the Boroff-Forman Fund for Health Policy. Harlan Krumholz, the Harold H. Hines, Jr. Professor of Medicine, served as moderator.
“I believe firmly the window for healthcare reform is about to open again,” Krumholz said. Describing the existing system as “financially toxic,” as well as inequitable, Krumholz said the country needs a stable system that also has room for innovation.
The panelists each expounded on this theme, saying that a combination of revamped policy and innovations born of business and medical partnerships are what’s needed to create a nimble, less expensive system that will emphasize value over volume.
“The real solution is a single-payer system, but I don’t see that happening in the next several decades,” said Lagarde, whose organization provides care for more than 19,000 low-income individuals.
As the process to reform healthcare continues, Lagarde said, focusing on three areas can help bring immediate improvement to healthcare systems. The measures include disincentivizing the fee-for-service model in order to emphasize quality of care over quantity, and the true integration of behavioral healthcare into primary healthcare.
Lagarde also called for a focus on social determinants of health, including most importantly adequate housing, which is critical to stability and health. “Healthcare is a basic human right, and as Americans, we have to deliver,” she said.
Slavitt said that the country is now at a precipice of determining whether it wants to proceed with reform or go “backwards.” The solution to a more just and affordable system, he said, lies at the intersection of policy and innovation.
Spending more on mental health and primary care, for instance, will save money in the long run, as it will reduce costly emergency care and hospital admissions, Slavitt said. He added that states, not the federal government, are leading the way in reform efforts right now, and
Connecticut—with its educated workforce and leading medical schools—is in a good position to make its mark. “We’ve got lots of room to start to work smarter,” he said.
Other states, including Massachusetts, have piloted novel measures to innovate around healthcare, and Connecticut needs to learn from, and build upon, their examples, Slavitt said.
Lamont said that while campaigning he has heard citizens across the state voice concerns over the affordability of healthcare, as well as the burden of rising taxes. But as a small state with a very diverse population, Connecticut can serve as a template for cost-saving healthcare innovation, he said.
A new ecosystem, featuring greater “cross-pollination” between the business, innovation, and governmental sectors, is needed. “As a governor, I’m going to have a different mix of people in the room,” Lamont said.
Connecticut’s strengths include robust businesses in the life sciences and biotech, advanced manufacturing capabilities, such as those in the southeastern part of the state, and major firms in the insurance industry, Lamont said.
But Lagarde stressed that, in her experience, innovators need support from the state to implement new ideas. “The sense [now] is if you want to get something done and you go to the state, it’s going to be very, very hard,” she said.