Kehaly: Arizona, let’s stand together for health care affordability

In a recent Pew Research study, reducing health care costs is the second-most-important priority for Americans.

And when it comes to health care, affordability is number one — From managing the most basic provider visits and medication to chronic conditions and complex treatments, every facet of the health care experience has seen huge cost increases.

This makes it even more challenging for Americans, including Arizonans, to access what they need to take charge of their health and well-being.

Consider that:

• Health spending increased by 9.7% from 2019 to 2020, much faster than the 4.3% increase from 2018 to 2019, according to Health System Tracker.
• Half of all adults report they have delayed or gone without certain medical care during the past year due to cost, while 29% also report not taking their medicines as prescribed due to cost, according to the Kaiser Family Foundation.

While the argument stands that cost pressures are real and require difficult conversations and creative solutions, it is counterintuitive for health care leaders to give up on lowering costs across the board — that is the easy way out and one we should not accept.

Some would say that the rising cost of medical care is the result of new medical technologies that allow better and faster diagnosing or improved surgical outcomes, or new drugs that cure or control chronic diseases. These are but a fraction of the increase in cost.

It is time that the health care community steps up to turn years of dialogue, discussion, and declarations into actionable change. Health care has reached a critical tipping point. Rising costs are unsustainable and it is time to correct course. Families should be able to meet their health care needs without fear of facing crushing debt.

Since individuals and families cannot negotiate their rates directly, we have become their advocates because it is the right thing to do. We aim to ensure that our more than 1.9 million members, and all Arizonans, get the most amount of health for every dollar spent on care. Every individual deserves quality, high-value, accessible care.

At Blue Cross Blue Shield of Arizona, our mission is to inspire health and make it easy, and we are committed to doing our part so that this trend does not continue.

But it is going to take all of us in the health care space to come together to:

• Be a bigger part of the solution: We are looking to provide a more comprehensive, end-to-end solution in support of our members’ health journey. This will mean interacting with care delivery in new and innovative ways to make health care more affordable, personal, and convenient.
• Work with providers, legislators, and community partners to make health care more affordable: We will continue to negotiate with providers and hospitals to get better rates for our members. It is only fair that we compensate, honor and respect providers for their talent; however, we must ensure that unnecessary increases, such as those that exceed medical inflation, are questioned and kept in check. Together, we can also work to educate policymakers and the public on health cost drivers and support public policy that protects Arizonans’ private health insurance and keeps health care costs from rising.
• Align incentives to pay providers for value over volume: It is crucial to move away from the sick care model way of thinking to paying for care to keep everyone as healthy as possible. We need to get creative to pay extra reimbursement for certain preventive measures, such as breast cancer screenings and well-child visits, and develop programs that ensure culturally competent, high-quality care that includes medication and disease management.
• Eliminate costs by streamlining processes: Navigating the health care system has grown increasingly complex over the past decade. It is time that we step back and reevaluate processes and remove complexity and unnecessary bureaucracy. For example, Blue Cross Blue Shield of Arizona has removed pre-auth requirements from providers who have a history of consistently operating within best practice guidelines.
• Invest in and support public and private initiatives to deal with pressing health issues: The Centers for Disease Control and Prevention identifies all 15 Arizona counties as socially vulnerable, with 11 of the 15 falling into the highest social vulnerability category.

Social vulnerability is a measure of 15 social factors — such as poverty, lack of vehicle access, and housing status — that show how vulnerable communities are to health threats. We believe investing in the community will address health care inequity and reduce the overall cost of medical care in the long run.

During the past three years, Blue Cross Blue Shield of Arizona has invested more than $20 million through 449 community partners supporting a range of public health and wellness issues.

Tackling rising health care costs is a team sport and requires all of us to step up and make a difference together.

It will require innovation, out-of-the-box thinking, and collaboration to move the needle, and I invite Arizona’s health care leaders to do their part. It is our obligation to ensure that we are good stewards of every health care dollar.

About the author

Pam Kehaly is president and CEO of Blue Cross Blue Shield of Arizona.