Local health-care execs: Current system ‘dysfunctional’

BOULDER — Dissatisfaction and frustration with the health-care system permeated the room Tuesday as local health-care executives discussed the future of relationships between patients, doctors, insurers and hospitals under the Affordable Care Act, more commonly known as ObamaCare.

Topics at BizWest’s CEO Roundtable on Health Care included skyrocketing insurance premiums and costs for health-care services, patients’ inability to choose their doctors, lack of pricing transparency before services are rendered, and alternatives for small businesses.

Nearly all were in agreement that the status quo is not working, and most were short on a solution.

“We have a dysfunctional ecosystem,” Dr. Clint Flanagan, co-founder of Nextera Healthcare Inc., said of the current system. “We’ve lost that doctor-patient relationship.” He said more people are traveling to urgent-care and emergency rooms for the types of conditions that can be taken care of by a primary-care doctor.

“The problem is that there are fewer and fewer primary-care practices. Doctors have become employees of hospitals.”

Craig Beyer, founder of Beyer Eyes, which provides full-service eye care, said, “We need free-market doctors.”

Flannigan said health care is no longer a relationship. “It’s become a transaction. Fewer docs are taking the path of primary care; they are becoming cardiologists and surgeons.”

Flanagan co-founded Nextera in 2011, which offers primary-care service to members for a monthly fee. “Insurance should be used for what all types of insurance is for — a catastrophe.”

Kendra Johnson, a benefits consultant with insurance brokerage Flood and Peterson, said the current system “is a mess.”

“Small businesses are being priced out of providing health insurance,” she said. “We’re talking with some of our clients about going to self-funded plans,” as insurance companies continue to raise deductibles, co-pays and monthly premiums.

Simon Smith, president and chief executive of Clinica Family Heath said serving those on Medicaid and those without insurance is a drain on the system. Brent Davis, chief financial officer of Avista Adventist Hospital, an affiliate of Centura Health, concurred that the Medicaid population is growing and causing pressure, and “the future is daunting with the aging population,” which mostly relies on Medicare.

Feeling like victims

Several roundtable participants shared personal experiences that left them feeling like victims of a system out of control.

Frank Bruno, president of the Boulder Community Health Foundation, said that after his back surgery at a different hospital system prior to his current employment, and thinking he had paid the bill, six months later he received a bill for $14,000 that looked differently from the bills he paid, but eerily were for some of the same services. He said it took a lot of time and effort to show the hospital he had been double-billed. “Something (in the system) is terribly broken.”

Gustav Hoyer, CEO of MyChoiceMD, a company that is working with physicians to shed light on pricing, said systemwide, “Patients don’t get treated like the customer. “How often do you go get a service, then get the cost later?” he asked. “Nobody can tell us how to fix this. … What we have now is a disaster.”

Davis said that in health care, every diagnosis and operation has variables that can’t be predetermined. “We are all made a little differently inside here,” he said, pointing to his chest. “We can only estimate. A lot of what happens can skew that estimate.”

Participants in Tuesday’s roundtable included: Craig Beyer, founder, Beyer Eyes; Frank Bruno, president, Boulder Community Health Foundation; Brent Davis, chief financial officer, Avista Adventist Hospital; Dr. Clint Flanagan, co-founder, Nextera Healthcare Inc.; Gustav Hoyer, chief executive, MyChoice MD; Kendra Johnson, benefits consultant, Flood and Peterson; Simon Smith, president and CEO, Clinica Family Health. Moderator: Christopher Wood, co-publisher/editor, BizWest Media LLC. Sponsors: Scott Gunter, EKS&H; Kathleen Alt and Jonathan Banashek, Berg Hill Greenleaf Ruscitti.

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