Issue link: https://beckershealthcare.uberflip.com/i/1336426
25 WOMEN'S LEADERSHIP 25 CEO / STRATEGY 5 healthcare policies more likely to pass with Democrats controlling Congress By Morgan Haefner F inal results from Georgia's two runoff elections mean several healthcare policies have a better chance of congressional approval. Democrat Raphael Warnock won a race against Repub- lican Sen. Kelly Loeffler, and Democrat Jon Ossoff beat David Perdue, The Washington Post reported Jan. 6. The Senate will now be a 50-50 tie, and Vice President-elect Kamala Harris will cast tiebreaking votes in the Senate, giv- ing Democrats control of the Senate, House of Representa- tives and White House. Several health policies stand an easier chance of being en- acted because of the Democratic majority. Larry Levitt, ex- ecutive vice president for health policy at the Kaiser Family Foundation, tweeted five Jan. 5: 1. Ending the lawsuit that aims to overturn the ACA 2. Giving premium assistance for ACA marketplace plans 3. Aiding states with more incentives to expand Medicaid 4. Letting the government negotiate drug prices 5. Eliminating cost-sharing for COVID-19 treatment But many analysts said they believe large, structural chang- es to the country's healthcare systems are out of reach. President-elect Joe Biden has said he doesn't support "Medicare for All," but even his proposed public option would face a harder road to approval, according to The New York Times. The public option aims to give Americans a choice between a public plan and private insurance. For most congressional legislation, procedural rules require 60 votes in the Senate. Because Democrats hold a slim ma- jority, they could use a tactic called reconciliation to pass healthcare legislation. Reconciliation allows lawmakers to pass some bills with the bare majority of votes, according to the Times. But recon- ciliation bills have to follow a requirement called the "Byrd Rule," which effectively says the legislative provisions have to be budgetary. This will be a challenge for sweeping health reform, the Times said. n 3 reasons Haven failed: A former healthcare CEO's take By Alia Paavola T here are three main reasons Haven, the healthcare venture formed by Amazon, Berkshire Hathaway and JPMorgan Chase, failed, according to a Jan. 5 Harvard Business Review article. e three corporate giants formed Haven in 2018 with an aim to lower healthcare costs for their 1.2 million workers, but the venture was unable to drive change in the industry. On Jan. 4, it announced to employees its intent to dissolve. Here is a breakdown of three reasons it failed, according to John Toussaint, MD, founder and executive chair of nonprofit educational institute Catalysis and former CEO of Appleton, Wis.-based edaCare, who penned the article. 1. Insufficient market power to shi costs. Although Amazon, Berkshire and JPMorgan have a combined 1.2 million employees, the companies didn't have enough market power to make providers lower their costs. is is because their employees are scattered across the U.S. Unless an employer group has about 50 percent of a local market, providers won't change their prices, Dr. Toussaint wrote. 2. Perverse incentives remain in the healthcare industry. Despite efforts to move to a more value-based, lower-cost system, the healthcare in- dustry still largely has fee-for-service reimbursement agreements. Since insurers and providers make big profits using the fee-for-service system and because there are few incentives to change, not many have adopted these new, at-risk payment models. As a result, Haven faced challenges to lower healthcare costs. 3. e COVID-19 pandemic. e third main reason was poor timing. When the pandemic emerged, providers shied their focus to managing the virus and the subsequent financial hit due to bans on nonurgent procedures. "Consequently, they are considering no new ideas until the crisis abates and even then, are unlikely to entertain taking on new risks," Dr. Toussaint wrote. n