ASPEN, Colo. — Advances in translational medicine and research. Top-quality clinical care and patient outcomes. Development of talent. All of these unite at academic medical centers, such as the University of Colorado Anschutz Medical Campus, clear-cut health care standouts looking to hold that status into the future.
As Elizabeth Concordia, president and CEO of University of Colorado Health, put it: "As a country we rely on academic medical centers to take care of all comers – traumas, burns, Medicare, Medicaid — you name it. If you’ve got a bad disease this is where you come for care."
But when it comes to paying for this progress, things get murkier. The thorny and complicated subject of health care economics filled much of a talk about "The Future of Health Care." A large audience turned out for the June 26 discussion, part of the Spotlight Health series at the Aspen Ideas Festival. The panel featured three leaders from the CU Anschutz Medical Campus: Concordia; Lilly Marks, vice president for health affairs for the University of Colorado; and Jena Hausmann, president and CEO of Children's Hospital Colorado.
A slide flanking the panel showed that the five-year survival rates for late-stage cancer patients of four different cancers, after treatment at the CU Cancer Center, were all significantly higher than national averages.
Concordia said such consistent outcomes — and the commitment to improve care through research and discovery — are at the heart of academic medical centers, but still, change is needed for the centers to remain competitive.
Consumers have more choices than ever. Concordia pointed out that while consumers are willing to spend more on a safer car, they gravitate to less-expensive insurance policies thinking they won't get sick.
"We have to try to educate people as to why we are important and the value we provide," she said. "We need to become more cost-effective and more consumer-oriented. But it's also unrealistic to think we're ever going to be cheaper or the same price as non-academic medical centers."
As innovators of care delivery, Concordia said, health care leaders need to push the envelope on models of effective, efficient care. She said it's not unrealistic to think that in 50 years a patient will sit at home and consult with a clinician who knows the person's complete health history.
"So when we look at the future of medicine, I think it behooves the academic medical centers to never take their eyes off the prize and make sure we focus on innovation, outcomes, quality and access ... but also we have to continue to focus on creating tomorrow's science," she said.
Hausmann used examples of recent patient care to illustrate how tomorrow's science is happening today at Children's Hospital Colorado. Academic medical centers lead in collaborations with other researchers and their relentless desire to innovate, she said. "That is the beauty and the spirit ... of academic medical centers."
But just as big data, personalized medicine and behavior changes have resulted in improved health, the backdrop in the United States — where health care costs make up 18 percent of the GDP — is that funding sources are increasingly under duress.
"It's like a giant shell game of moving money around to figure out on any given day how you're going to use these resources to fund these advances," Marks said.
She noted that “we're at the inflection point” in medicine of being able to predict, prevent, diagnose and treat disease. Academic medical centers are investing "hundreds of millions of dollars" to pursue research — largely through redeployment of clinical revenues, in the face of flat federal funding from the National Institutes of Health (NIH) — while also working hard to bring costs down, she said. For every dollar it receives from extramural sources, such as the NIH, CU Anschutz Medical Campus invests 53 cents of its own money to augment the research enterprise, Marks said.
Meanwhile, health care costs continue to shift to patients. Currently, individuals cover about 28 percent of costs, compared to 26 percent by the government and about 21 percent by employers, Marks said. "Health care economics is complicated. It's incumbent on all of us to become more informed as consumers of how we interact with that system."
The Q&A session began with a question about health care economics. An audience member said he agreed with Concordia's view that "we can't wellness our way out of all the challenges we have (in health care)" but conversely, he wonders how it's possible to effectively treat all serious-disease cases in a U.S. health care system that runs a multi-trillion-dollar tab annually. "Where's the sweet spot?" he asked.
The ideal, Concordia said, is to provide care that is prevention-oriented, has flexible delivery methods, and looks at an individual's treatment from a longitudinal and cost-effective perspective. "The more sophisticated and advanced we become the more we'll be able to target and understand that a drug may not be effective ... Drug expenses in the total cost of care are significant."
Moderator Todd Breyfogle asked the panelists what they view as the biggest impediment to an ideal health care system of the future. Concordia said the provider reimbursement system is a problem area. Hausmann pinpointed the state and federal regulatory environment for health care, one of the most-regulated sectors of the economy. "Changes to the regulatory environment are not keeping up with the pace of innovation and transformational care," she said.
Marks views political rhetoric as a significant impediment to making progress in health care. "We need to be talking about the facts and the data rather than all the rhetoric," she said.
The high-profile Spotlight Health forum is an ideal platform on which to raise the profile of the CU Anschutz Medical Campus.
"The festival takes place in Aspen, our own backyard, and attracts attendees from around the country and the world," said Leanna Clark, vice chancellor of University Communications. "The Spotlight Health focus ensures that we are getting the Anschutz Medical Campus brand in front of the foremost academics, policy makers, practitioners, industry executives, philanthropists and concerned citizens, and engaging them in the conversation to transform health and health care.”
The Aspen Institute invited a group of "Spotlight Scholars" to attend the conference in recognition of their academic accomplishments and ability to translate ideas into action. Four scholars represented the CU Anschutz Medical Campus: Brandi Freeman, MD, assistant professor, Pediatrics-General Pediatrics; Jason Stoneback, MD, Department of Orthopedics; Roberta Capp, assistant professor, Emergency Medicine; and Christopher Porter, MD, assistant professor, Pediatrics-Hematology/Oncology.
Published June 30, 2015
Contact: Christopher.casey@ucdenver.edu