Leslie V. Norwalk, Strategic Counsel at Epstein Becker Green and EBG Advisors, Inc., in the firm’s Washington, DC, office, was quoted in the Arcadia Solutions Blog, in “Highlights from Arcadia Aggregate2018,” by Richard Parker.

Following is an excerpt:

Our second annual industry conference Arcadia Aggregate2018 brought over 150 healthcare executives, thought leaders, and analysts together for insight into the challenges and opportunities for healthcare in 2018. Our chief medical officer Rich Parker, MD shares his favorite highlights. …

Leslie Norwalk, JD, strategic counsel to Epstein Becker Green and former acting administrator for CMS in the Bush administration, delivered a keynote address.

If anyone is well-positioned to comment on federal healthcare policy priorities, it would be Leslie Norwalk, who explained that “personnel is policy” – the idea that it is the people who shape and define the policies.

Leslie described how our new Secretary of Health and Human Services Alex Azar has four priorities for the U.S. healthcare system:

  1. Decrease cost
  2. Continue the value based transformation of healthcare
  3. Address the opioid crisis
  4. Decrease drug prices

She focused much of her talk on the inexorable rise in healthcare costs, noting that the current total expenditure of $3.7 trillion is projected to rise to $5.6 trillion in 2025. “Medicare and Medicaid take up 27% of the entire federal budget.”  Leslie brought up some key points that “highlight the vulnerability of the system as we march into the future”:

  • 11,000 Americans enter Medicare daily
  • Within the Medicare system, the ratio of workers to patients in 1965 was 4 to 1. In 2017, it was 3 to 1. In 2050, it is projected to be 2 to 1.
  • 30% 0f Medicare spending is on the 5% of patients who die each year.
  • 14% of patients with more than 6 medical conditions account for 62% of all Medicare spending, highlighting the need for greater attention to chronic conditions

One of our customers asked Leslie why the Medicare Payment Advisory Commision (MedPAC) appears to be backing off on risk-based contracting.  Leslie replied, “most doctors can’t handle risk – unless they have a partner like Arcadia.”  She concluded by affirming that “risk is necessary to control utilization and spending excesses.”  We couldn’t agree more!

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