AHIP Day One – Passion in the Streets

blogger-healthreformFresh blog from the floor of AHIP San Diego. AHIP (America’s Health Insurance Plans) is having its annual meeting in San Diego this week.  Here is a recap of June 3, 2009, the first day.

Last year at AHIP, health care reform was discussed, but most political commentators didn’t think much would happen: there was interest, but not passion.  This year the passion has spilled onto the streets.

January 2009, the OMB made a statement that has remained at the center of where we are today- we cannot fix the economy unless we fix health care.

Of the significant debt we are now assuming with the new budget- $35 trillion of that debt is Medicare. We can’t fix the economy if we don’t fix health care.

One vendor’s health care reform includes four components developed sequentially. First is establishing a solid health information technology structure that we don’t have today. Second is focusing more intently on comparative effectiveness and evidence-based service delivery, third is coordinating care, and fourth is consumerism. All of these components are being discussed. Will we have time execute sequentially as opposed to combining these into a parallel path? The group estimated that this would take six to ten years to put the model in place, but do we have the time?

At a completely different end of the spectrum, there are also protests being organized, to show the angst developing in the industry.  Nurses from the California Nurses Association and allies from groups like Physicians for a National Health Program and Progressive Democrats of America will be there to greet health plan executives.  Their tone is extremely hostile in some cases, calling the insurance industry some surprisingly caustic names.

Our view: HIPAA standards promise to improve health care, but we cannot wait.  Embracing the standard, technology, people and process must proceed briskly.  This is a challenge as member premiums have declined with unemployment ranks rising. Click here for our report on mentoring health payers and providers on embracing HIPAA standards and improving process.

The exhibit hall is smaller this year given budget constraints. However, we will spend more time there on day two.

Michael Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, stutdies at Harvard Law School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims).

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