Afternoon Keynote: "The Future of Arizona Health Care" - State of Reform - State of Reform

Eli Kirshbaum | Dec 4, 2020

Four prominent health care leaders discussed the future of Arizona health care during the afternoon keynote at State of Reform’s 2020 Arizona Virtual Health Policy Conference.

The CEO of Bluecross Blueshield Arizona Pam Kehaly praised the unique way in which health care leaders around Arizona worked together to address the impacts of COVID-19.

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“The health sector came together in a way I don’t think it ever has in the history of Arizona,” she said. “The CEOs of all the major health systems, the CEOs of the not-for-profit insurance companies, and the CEOs of insurance companies started meeting on a regular basis and working on the challenges of COVID.”

Kehaly contrasted this with the tension and the “bureaucracy” often seen between insurance companies and medical delivery systems. She hopes this cooperation continues after the pandemic.

Ann-Marie Alameddin, Chief Executive Officer of the Arizona Hospital and Health Care Association, echoed Kehaly’s sentiment and said health systems coming together and building relationships has been crucial to Arizona’s response to COVID-19.

“We are acting as we should in a public health emergency, and this is that we are acting as a health system,” she said. “We’re not acting in our own particular silos. We’re a health care system and we have a mission, and we’re focused on public health measures, interventions, saving lives, and keeping people healthy.”

Sen. Vince Leach, Vice Chair of the Arizona Senate Appropriations Committee, spoke about the billion dollar shortfall induced by the pandemic and the Appropriations Committee’s quick budgetary response.

“We did something which is unheard of in the legislature,” he said. “We had a bipartisan skinny budget put together within four days and the Senate voted on it and sent it to the House.”

He credits the state legislature’s cross-party cooperation with passing a balanced budget in the midst of the immense economic issues brought by the pandemic. Legislators recognized there was a time-sensitive budgetary problem on their hands and they needed to come together to solve it, he said.

“It was a collaboration,” he said. “Could that ever be replicated in a very partisan situation? I don’t know. But I know that we did it once and I’m sure that we can do it again.”

CEO of ConsejoSano Abner Mason described his organization’s role in broadening health care access to diverse communities. Arizona is close to becoming a majority-minority state, he said.

“Our health care system is just not well-equipped to serve the country we have become,” said Mason. “We’re much more multicultural now.”

The country’s current health care system does not represent that multiculturalism, according to Mason. For instance, health care language is often only written in English or poorly translated.

“What ConsejoSano is doing is using technology and data to understand who people are at a deeper cultural level and then engage with them in that way,” said Mason. “We’re getting great results because we’re able to build that trust and to have an engagement with the member or patient that’s two-way and allows us to navigate them to health care at the right time and the right place.”

He emphasized the need for better metrics on who is left out of health care services. A lot of health systems around the country do not collect data on race and ethnicity, he said.

Leaders should also examine how regulations prevent access to health care, Mason said. He referred to telehealth and how federal barriers were only removed after the pandemic increased demand for telehealth services.

Panelists spoke about the lack of trust in the new COVID-19 vaccines and how to respond to groups who have indicated they would refuse to get vaccinated.

According to Mason, more than 50% of African Americans and nearly 40% of Latinx people are unwilling to receive the vaccine.

Kehaly explained fixing the trust problem is difficult but assured BlueCross BlueShield is committed to fostering trust by communicating effectively to the community.

“We are very focused on communications,” she said. “We are focused on following through on our commitments to build that trust. We know how important trust is — we measure it with our population on a regular basis with surveys and we measure our net promoter score. One thing that we have seen through the COVID pandemic is our net promoters have gone up significantly, and that is because insurance companies amped up the communication and reach-outs to their memberships because of COVID.”

When asked whether the imminent Biden transition, Senator-elect Mark Kelly’s win, and the 1115 Waiver renewal will increase Arizona’s cooperation with the federal government, Alameddin said the new administration would push the state towards implementing broader health care coverage.

“During the Trump Administration, we saw a weakening of the Affordable Care Act,” she said. “If it wasn’t able to be accomplished legislatively, there was administrative weakening. So I think we’ll see a definite pivot toward strengthening the Affordable Care Act, to increasing marketplace competition through the exchanges and going more towards value-based care.”

Kehaly said the results of the Georgia Senate run-off election will have a huge influence on whether or not universal coverage will be achievable. 

“If we don’t have a split Congress, there is an opportunity for Biden to push through some sort of public option,” she said. “That is as close as the United States is going to get to universal health care.

She is “all for” universal coverage but has concerns about Biden’s public option plan. The insurance companies would not be making a profit off of the public option, she explained.

“This would be a disaster for the medical delivery system from a financial perspective,” she said. “I don’t see it [universal coverage] happening soon. I think we’ll chip away at it, and again it’ll depend on Georgia of all places.”

Each panelist was also asked what accomplishments they hope to look back on and be proud of.

Sen. Leach said he hopes to see a reduction in regulations and praised Arizona’s removal of state regulations that limited health care workers’ ability to be licensed in another state. 

Alameddin hopes Arizona takes aggressive public health action, flattens the curve, and saves lives.

Abner wants to see the country successfully administer vaccines that take health inequities into account rather than reinforcing them.

Kehaly wants Arizona to set the model for the rest of the country by delivering “affordable, simple, and convenient” health care to every Arizonan.

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