Health care in Central Mass. is at an inflection point, WBJ panelists say

Photo | Grant Welker UMass Medical School in Worcester

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The healthcare system is in a moment of transition, according to panelists and speakers at WBJ’s annual Health Care Forum.

On both the federal and local levels, healthcare leaders are at a crossroads as they tackle not only the coronavirus pandemic, but also the many industry challenges the pandemic has highlighted or exacerbated, including a daunting workforce shortage and inequities in access to care, more broadly.

Inherent to these challenges are getting people covered by health insurance in the first place, as well as regulating the cost of care, said keynote speaker Dr. Jonathan Gruber, Ford professor of economics at Massachusetts Institute of Technology in Cambridge, and former healthcare program director at the National Bureau of Economic Research.

“Healthcare premiums continue to go up, but they’re going up at a slower rate than they were before the exchanges were introduced,” Gruber said during a talk which launched the panel event, referencing state healthcare exchanges established as part of the U.S. Affordable Care Act.

From Gruber’s vantage point, it’s not so much the cost of health care needing to be lowered in the United States, but rather the rate at which costs are expanding. While other countries have opted to regulate costs in the industry, he said, the United States does not.

“The private market is not capable of addressing the underlying high cost of health care,” Gruber said.

And on the other hand, against the politically volatile backdrop of the ACA, many eligible for free healthcare coverage simply aren’t signing up for it, Gruber said. In response, he promoted the idea of automatic enrollment for people who fall within that category. Even that, he said, would far from bring the country to a point where 100% of its population had coverage. One-third of those uncovered by health insurance are undocumented, with no political interest in fixing that, he said.

“This is not moving us to universal coverage by any sense of the term.”

Still, he argued, compulsory enrollment and improving healthcare choices could do a lot in the way of addressing the problem.

Local challenges

On the local healthcare front, organizations in Central Massachusetts are facing many of the same problem plaguing healthcare networks and their partners across the country, according to the event’s panelists, which included Ken Bates, president and CEO of Worcester nonprofit Open Sky Community Services, Richard Burke, president and CEO of Worcester insurer Fallon Health, and Lisa Colombo, executive vice chancellor of Commonwealth Medicine at UMass Chan Medical School in Worcester.

Equitable access to care, workforce pipelining and retention, and shifts in healthcare delivery, including the expansion of telehealth, are all reshaping the face of the industry in and around Worcester, panelists agreed.

An ongoing healthcare worker shortage, coupled with healthcare disparities highlighted by the pandemic, were issues that reared their heads more than any others during the length of the discussion.

“In my 20+ years of working in this field, I have never seen as much attention to [healthcare disparities] as I’ve seen right now, and the problem has existed for really forever,” said Burke. “So, I think the No. 1 thing is that we take advantage and not miss this moment when so many people are talking about health equity and disparities in delivery of health care.”

That includes accountability on behalf of industry stakeholders, understanding gaps in access to health coverage, screening health-related social needs, and ensuring people from all socioeconomic backgrounds have access to services often harder for them to reach, like behavioral health care, the panelists said, as well as making sure behavioral healthcare workers are paid equitably.

In many ways, with the pandemic now entering its third calendar year, the healthcare industry is at an inflection point, panelists said. While they have faced increased pressure from virtually every angle, there is also the opportunity to reform and revamp how care is delivered.

To do so, all agreed, will require stakeholders working together.