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Tech innovators, not legislation, poised to disrupt health care delivery
ORLANDO, Fla. — Legislative efforts to repeal and replace the Affordable Care Act seem unlikely to significantly impact health care delivery for providers, but technological innovators like Amazon are poised to cause a massive disruption, according to a presenter at Advances in IBD 2017.
John I. Allen, MD, MBA, of the University of Michigan, emphasized these two main points during his talk regarding the future of care for patients with inflammatory bowel disease.
“What’s going on in legislation right now has very little to do with health care delivery in your practices,” he said. “Every legislative piece that was a repeal and replace of the ACA was really a tax act, and not a health care act — it was a ramp up for the current tax reduction and tax reformation, so that really isn’t going to affect our delivery of care. The second point is that the delivery of care to our patients is going to be massively disrupted, and it’s going to be disrupted by an entity outside of medicine and outside of the federal and state governments. It’s going to be disrupted by companies like Amazon,” which he noted has recently made large investments in health care technology.
This coming tech disruption as essentially inevitable, he said, and driven by the movement toward patient-centered health care delivery.
“How many in here remember walking into a bank to get their money, and then think now, how often do you go to a bank ever?” he said. “We talk about a patient-centric delivery of health care, and I would say that we could not design a more provider-centric infrastructure of health care and reimbursement structure of health care than we have right now, and that’s ripe for disruption.”
Need for cooperation
However, Allen emphasized that recently proposed Republican health care laws would have been catastrophic for patients with inflammatory bowel disease, and called on physicians to advocate for “a coherent plan forward.”
He shared his desire for providers to become more active in the political arena, “because I will tell you that if any of the legislations of repeal and replace had been passed, our IBD patients would have basically been thrown off the cliff — it would have been an unmitigated disaster.”
These laws would have especially impacted young IBD patients, he said. For example, young adults benefited most from the ACA, with their uninsured rate dropping from over 30% in 2010 to about 15% in 2016.
“If you think about the typical IBD patient being a young working adult, probably between 18 and 29 in many cases, the uninsured rate for that group has markedly gone down, and of course the repeal and replace bills would absolutely reverse that,” he said.
In addition, if any of the recently proposed health care legislation had passed, 24 million people would lose coverage by 2026, and if the Graham-Cassidy bill waiving the essential benefit mandate had been passed, premium surcharges for rheumatoid arthritis — which was “as close as we can come to IBD” in the given analysis — would be about $26,000 on top of patient premiums to gain coverage if their state waived essential benefits, Allen said.
“What’s happening in the legislation, we have to pay critical attention to, because if the finances for health care go down in a targeted way for patients with chronic diseases and high-risk pools, that’s going to be devastating for the patients that we take care of,” he said. “So wherever your political leanings are, we have to come together to put together a coherent plan forward, or it’s going to affect us in ways I think will be absolutely tragic.” – by Adam Leitenberger
Reference: Allen JI. Clinical Session IIA. Presented at: Advances in IBD; Nov. 9-11, 2017; Orlando, Fla.
Disclosures: Allen reports financial relationships with The Alliance, the Crohn’s and Colitis Foundation, GI View, IBD Qorus, the Impleo NECTAR Study and Responsive Health.