Event: The National Business Coalition on Health Annual Conference
Date: November 5-7, the Astor Crowne Plaza Hotel, New Orleans

What: The membership of the National Business Coalition on Health (NBCH) includes nearly 80 employer-led coalitions across the United States, representing more than 10,000 employers and approximately 34 million employees and their dependents. The NBCH is dedicated to making the coalition movement the vehicle for meaningful change in the health care system throughout the United States.

Conference info: For more information on the annual conference, go to http://www.nbch.org/events/conference.cfm.

Conference Notes—Day 3, Tuesday, November 7, 2006

The eye of Newt: Twelve years after he led a Republican takeover of Congress and on the day when that control was ceded to Democrats, Newt Gingrich gave a keynote address that may have been his version of a health care stump speech. He laid out a vision for what he called real change in the health care system.

Keynote speeches, like leaders, are meant to inspire others to continue working toward ambitious goals. So many keynotes, like leaders, feel as fresh as recycled air. Judging by the standing ovation Gingrich received from the audience, the former House speaker’s keynote address was a success.

The health care world according to Newt can be summarized by any number of his own maxims and Ben Franklinisms. Some are specific to health care, others to the nature of commerce in the 21st century.

Others reflect the musings of a leader on leadership. Gingrich is well aware that transforming health care (after all, his organization is called the Center for Health Transformation) requires a kind of inspirational leadership that allows for ambitious goals mixed with discipline--a combination that is required to change the status quo.

On changing a health care system that is expensive, threatens American competitiveness in the world and kills tens of thousands of patients each year, Gingrich offered several insights, including his "Four Key Drivers of Health Transformation":

    1. Focusing on avoiding medical errors by improving patient safety and patient outcomes or health.
    2. Information and communication technology.
    3. A system and culture that, like the transformation of the American automobile industry 25 years ago, focuses on quality.
    4. Individual knowledge, responsibility and choice.

Metrics are at the heart of change: "The most important breakthrough of the next 15 years," Gingrich says. Real metrics start with real questions. Gingrich uses the New York Police Department's metrics tool, CompStat, which tracks crime and was developed by former NYPD Commissioner William Bratton. Real data will come through mining and aggregating health claims and putting it online.

Five keys for any leader, according to Gingrich:

    1. The leader must want different results.
    2. Real change will require real change. Define your vision and go for it.
    3. Learn to say, "Yes, if" rather than "No, because." This leads to creative solutions and positive thinking within a team. Someone asks, "Can we order pizza for lunch?" A "Yes, if" answer is: Yes, if we can scrounge up $10. A "No, because" answer is: No, because we don't have $10.
    4. New results require new ideas, new actions and, sometimes, new structures and new cultures.
    5. Look for and adopt what is already working.

Must-reads: The top seven titles, according to Gingrich, including (surprise!) his three latest books:

    1. The Art of Transformation, Newt Gingrich
    2. The Effective Executive, Peter Drucker
    3. Leadership, Rudolph Giuliani
    4. Turnaround, William Bratton
    5. Moneyball, Michael Lewis
    6. Winning the Future, Newt Gingrich
    7. Saving Lives and Saving Money, Newt Gingrich
--Jeremy Smerd

Conference Notes—Day 2, Monday, November 6, 2006

Katrina and health care: Hurricane Katrina and health care once again collided here at the Astor Crowne Plaza Hotel in New Orleans, where the National Business Coalition is meeting for the employer-sponsored group's annual conference.

The storms and ensuing floods closed the city's public hospital for good. Flooding wiped out the health care system and afforded employers the opportunity to work with public health officials, hospitals and doctors to remake a broken health system by focusing on health care quality and cost. This is now a major focus of the state-run Louisiana Health Care Redesign Collaborative, which was created in July.

Since then, the collaborative has submitted a proposal to the federal government for remaking the state's health care system that could be a model for the rest of the country by reducing the number of uninsured and improving the quality and cost of health care.

The heads of employer health care coalitions in Minnesota, Seattle and Detroit spoke about the need to get chief executives of local companies involved in health care. By using the power of the executive suite, business leaders can push for health plans to rate their doctors and hospitals.

The plans with the best networks would compete for business. In Minnesota, this has allowed employers to steer employees to doctors who provide better health care and improve the health of employees.
—JS

Conference Notes—Day 1, Sunday, November 5, 2006

Hurricane Katrina is not a thing of the past for New Orleans. Likewise, rising health care costs threaten every day to depress wages and stagnate business growth. That may seem an odd comparison, but in New Orleans everything still has the whiff of Katrina about it.

When the storm hit and the levees broke more than a year ago, this hotel became a refugee center for more than 2,000 people. Today, the hotel at the corner of Canal and Bourbon streets is hosting the National Business Coalition on Health's annual conference, a group composed of large employers across the country who are working, in their regions and nationally, to lower the cost of health care while also improving the quality of medicine.

The three-day conference began Sunday, and rising costs are still the No. 1 concern among employers. Another speaker was Dennis White, who directs an employer-sponsored project called evalue.org, which is aimed at using health claims data to rate doctors. Part of the aim of the project is to use those ratings so that good doctors are well compensated and bad medical care is not paid for.

Christine Whipple, director of the Pittsburgh Business Group on Health, talked about implementing the Asheville Project among some of her employer members.

The Asheville Project is a program designed to reduce the costs of diabetes by making sure diabetic employees get the treatment they need using incentives such as waived co-pays for those who meet with pharmacists and take the drugs they need to keep them healthy. It is working, and one employer wants to take the program to its other sites across the country. The question is, how?

These questions and others will be addressed during the next two days. Former House Speaker Newt Gingrich will be speaking, as will Julie Gerberding, director of the Centers for Disease Control and Prevention.
--Jeremy Smerd