Let’s Stand Together for Affordability

In a recent Pew Research study, reducing healthcare costs is the second most important priority for Americans. And when it comes to healthcare, affordability is number one. From managing the most basic provider visits and medication to chronic conditions and complex procedures and treatments, every facet of the healthcare experience has seen huge cost increases. This makes it even more challenging for Americans, including Arizonans, to access what they need to take charge of their health and well-being.  

 Consider that:  

• Health spending increased by 9.7% from 2019 to 2020, much faster than the 4.3% increase from 2018 to 2019, according to Health System Tracker.
• Half of all adults report they have delayed or gone without certain medical care during the past year due to cost, while 29% also report not taking their medicines as prescribed due to cost, according to the Kaiser Family Foundation. 

While the argument stands that cost pressures are real and require difficult conversations and creative solutions, it is counterintuitive for healthcare leaders to give up on lowering costs across the board – that is the easy way out and one we should not accept.  

Some would say that the rising cost of medical care is the result of new medical technologies that allow better and faster diagnosing or improved surgical outcomes, or new drugs that cure or control chronic diseases. These are but a fraction of the increase in cost.  

 It is time that the healthcare community step up to turn years of dialogue, discussion, and declarations into actionable change. Healthcare has reached a critical tipping point. Rising costs are unsustainable and it’s time to correct course. Families should be able to meet their healthcare needs without fear of facing crushing debt. 

 Since individuals and families cannot negotiate their rates directly, we have become their advocates because it is the right thing to do. We aim to ensure that our members, and all Arizonans, get the most amount of health for every dollar spent on care. Every individual deserves quality, high-value, accessible care.  

As the leading health insurer in the state, Blue Cross Blue Shield of Arizona has been gathering the best minds, data, and strategies to manage medical costs for our more than 1.9 million members and Arizona’s communities. As an Arizonan, I’m proud to say that healthcare leaders in our state have been working hard to ensure affordability. 

At BCBSAZ, our mission is to inspire health and make it easy, and we are committed to doing our part so that this trend does not continue. But it’s going to take all of us in the healthcare space to come together to: 

 Be a bigger part of the solution.  

We are taking bold steps to uplift health coverage and care in Arizona. As such, we will look to provide a more comprehensive, end-to-end solution in support of our members' health journey. This will mean interacting with care delivery in new and innovative ways to make healthcare more affordable, personal, and convenient. 

Work with providers, legislators, and community partners to make healthcare more affordable.  

We will continue to negotiate with providers and hospitals to get better rates for our members. It’s only fair that we compensate, honor, and respect providers for their talent, however we must ensure that unnecessary increases, such as those that exceed medical inflation, are questioned and kept in check. Together, we can also work to educate policymakers and the public on health cost drivers and support public policy that protects Arizonans’ private health insurance and keeps healthcare costs from rising. 

Align incentives to pay providers for value over volume.  

It’s crucial to move away from the sick care model way of thinking to paying for care to keep everyone as healthy as possible. We need to get creative to pay extra reimbursement for certain preventive measures, such as breast cancer screenings and well-child visits, and develop programs that ensure culturally competent, high-quality care that includes medication and disease management.  

Eliminate costs by streamlining processes – making it easy.  

Navigating the healthcare system has grown increasingly complex over the past decade. It is time that we step back and reevaluate processes and remove complexity and unnecessary bureaucracy. For example, BCBSAZ has removed pre-authorization requirements from providers who have a history of consistently operating within best practice guidelines. To identify additional opportunities, we have created a cross-functional “experience team” that is tackling how to make it easier for members, providers, and employers.  

Invest in and support public and private initiatives to deal with pressing health issues.  

The CDC identifies all 15 Arizona counties as socially vulnerable, with 11 of the 15 falling into the highest social vulnerability category. Social vulnerability is a measure of 15 social factors, like poverty, lack of vehicle access, and housing status, that show how vulnerable communities are to health threats. We believe investing in the community will address healthcare inequity and reduce the overall cost of medical care in the long run. During the past three years, BCBSAZ has invested more than $20 million through 449 community partners supporting a range of public health and wellness issues.  

Tackling rising healthcare costs is a team sport and requires all of us to step up and make a difference together. It will require innovation, out of the box thinking, and collaboration to move the needle and I invite Arizona’s healthcare leaders to do their part. It’s our obligation to ensure that we are good stewards of every healthcare dollar. 

Pam Kehaly is President & Chief Executive Officer at Blue Cross Blue Shield of Arizona. For more information about BCBSAZ, visit azblue.com.