The University of Miami Patti and Allan Herbert Business School presented its ninth annual Business of Healthcare conference virtually on Friday, October 30. This program is produced annually by the Miami Herbert Business School Center for Health Management and Policy. The business school is renowned for its Health Executive MBA, the highest ranked (by U.S. News & World Report), longest running health executive MBA in the region. Aside from opening/closing remarks and scheduled breaks, the conference consisted of three principal segments labeled Keynote Panels:

• After the Pandemic: Building a Better Normal
• Health Care Access, People & Policy, COVID-19 & Beyond
• Diversity & Inclusion: Providers, Patients & Community

The second segment of the program, focusing on health care access, featured a panel of Matthew D. Eyles, President and Chief Operating Officer, America’s Health Insurance Plans; Joseph Fifer, President and Chief Executive Officer, Healthcare Financial Management Association; Halee Fischer-Wright, MD, President and Chief Executive Officer, Medical Group Management Association; Ernest Grant, President, American Nurses Association; Barbara L. McAneny, MD, Former President, American Medical Association, Chief Executive Officer, New Mexico Oncology Hematology Consultants, Ltd. and Richard J. Pollack, President and Chief Executive Officer, American Hospital Association. This segment of the conference was moderated by Pat Geraghty, President and Chief Executive Officer, Florida Blue and GuideWell. Of the three Keynote Panels, this presentation featured the largest and most diverse group of speakers.

Mr. Eyles set the tone of the conversation by suggesting that most Americans believe we have a high-quality health system, but it is too costly, and access is inconsistent. And clearly cost and access are closely related concepts. Mr. Grant insisted that we must revisit public health. “There is a lack of investment in vulnerable communities,” according to Grant. And investment in the underserved is not merely a humanitarian goal. “These are essential workers,” he pointed out. Dr. McAneny echoed Mr. Grant’s concerns regarding lack of investment. She stated that the physician fee schedule has only increased by 6% since the early 2000’s. According to the Bureau of Labor Statistics consumer price index, today’s prices in 2020 are 33.27% higher than average prices since 2005. This means physician are falling behind. “Medical practices are being starved,” stated Dr. McAneny.

Not all sectors of the healthcare space lack funding, however. Dr. Fischer-Wright asserted that $35 billion was invested in medical practices last year – mostly from private equity and venture capital. “Money going into medical practices generates that first wave of transformation necessary to address cost and access issues,” she stated. Mr. Fifer noted that the big money being invested in the health sector is not going into in-patient care. He also pointed out that there are lots of non-traditional players in the healthcare space currently, e.g. Teladoc, Livongo and Apple. Mr. Pollack agreed with Mr. Fifer regarding investment flow. He predicts “a race to provide healthcare in the home.”

Mr. Pollack also expressed concerns about hospital finances. Hospitals faced a COVID driven triple whammy of lost revenue, accelerated costs and increased uninsured care burden. For hospitals, “This was the biggest financial crisis of all time,” he stated.

The way forward is murky. Several panelists noted that the allocation of capital in the healthcare sector is far from optimal. “The private equity model bothers me,” stated Dr. McAneny. “Investors are pulling out massive profits while patients are losing their health benefits.” Mr. Pifer pointed out that the transformation of the health sector will be disruptive. Millions of healthcare workers will be financially affected by the inevitable changes in the health industry. “We need to face the elephant in the room,” he stated. Mr. Eyles struck a hopeful chord noting the powerful role technology will play in the management of chronic disease and addressing social determinants of health.

All panelists agreed that the long game for solving the healthcare access dilemma requires transforming our system to one that truly provides healthcare instead of the current model with its emphasis on “sick care.” One good way to expand access is to make sure everyone has health insurance. In the U.S., the Affordable Care Act (ACA) was created to serve the nation’s uninsured and under-insured. Critics of this controversial law assert that the ACA is too expensive and has fallen short of its goals. The U.S. Supreme Court is currently hearing a case regarding the constitutionality of the ACA. Despite the law’s flaws, all panelists agreed – in a vote led by Mr. Geraghty – that the ACA should stand.

With just two months left in a difficult year, most Americans are looking forward to a new beginning in 2021. These six panelists provided insights and observations to aid in that journey.