WHCC19 | Interviews

Melissa Cohen
Staff VP, Payment Innovation Strategy
Anthem


What is the top challenge or obstacle facing health care today?
I think our greatest challenges are the ways we pay for care and the mismatch between how much we pay and the actual value of the care. The old fee-for-service system incentivizes high volume, and the uneven value/payment equation is the reason we spend far more as a country on specialty care than on primary care.

The work my team does is part of a system-wide shift away from the fee-for-service system and toward one that aligns payment with value.

What story or theme has impacted health care the most over the last two years?
I think there are two opposing themes: Consolidation, which can make health care feel more impersonal as large health systewms manage more care, and the digital innovations that allow for very personalized care.

Anthem is using its market position to launch large-scale value-based payment arrangements with big health systems and, at the same time, building digital, consumer-centric solutions.

How are you preparing your organization for an uncertain future?
By focusing on what we can control and earning our place in the health care system. Our company at its core is about being a trusted partner - we are being strategic about which providers we work with. We are building solutions around the highest performers and guiding members to those doctors and hospitals by offering transparency around cost and quality, helping consumers make the best choices.

What has you most optimistic about the future of health care?
When we talk to clients now, they ask that we think about ways of integrating programs that address social determinants of health, like food and transportation, into benefit design. And when we talk to providers, they recognize they have a role to play in addressing those health drivers outside their office walls. That's one area as an industry I am happy to see us stepping up to the plate.

What's one life hack that you have to make your day-to-day life more productive?
I block time on my calendar so I have time to think strategically about how to move work forward, allow time to read health policy news, and essentially 'zoom out' so I'm not stuck in the day-to-day.



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