In today’s episode I’m excited to have Matt Eyles, president and CEO of America’s Health Insurance plans, known as AHIP, the national trade association of health insurance providers. Matt has more than two decades of healthcare experience in the private sector and in government. He’s led teams at Fortune 200 healthcare companies in diverse roles, including public policy, government affairs, advocacy, and corporate communications, with both a U.S. and a global focus. He’s been named a healthcare power player by Business Insider, and among the 100 most influential people in healthcare by Modern Healthcare. Matt began his career at the congressional budget office covering healthcare, budget, and regulatory policy.
Bill Frist: Matt, there’s so many things I want to talk about today. We’ve got surprise bills. We’ve got transparency, we’ve got drug pricing, we’ve got Medicare for all. There’s so much I want to talk to you about. But let’s really step back, and really for our viewers, AHIP, the organization that you are the director, the lead on, what is AHIP?
Matt Eyles: Sure. AHIP. It’s short for America’s Health Insurance Plans. And we’re the national trade association that represents all health insurance providers across the entire country. So we represent big national plans. We represent Blue Cross Blue Shield plans. We represent local and regional plans that might just operate in one part of the country. We even represent companies that might be in one particular program or line of business, so for example, Medicaid health plans. And so we advocate on behalf of them. But we really try and do it by focusing on what’s best for the consumer, how do we improve affordability of the system, and how do we really enhance coverage and health across the country.
Bill Frist: Mm-hmm (affirmative). So you represent … we’re today in Washington D.C. where A Second Opinion came to interview you. And you’re based here, but you represent … is there a number of plans or a percentage of the healthcare plans that you represent?
Matt Eyles: Great question. So we have about 150 members. We represent well over 2/3 of the entire health insurance industry, and about 250 million or so covered lives in the United States, across all different lines of business. We even represent plans that offer dental coverage, vision coverage, Medicare supplement coverage. Comprehensive medical plan coverage is our bread and butter, but we do operate in other areas as well.
Bill Frist: Yeah. A couple of basic questions that if I were listening to us now I’d say, “Okay.” An insurance plan, that is what? And I think insurance is basically to take these exceptional occurrences that come through life and to smooth it out in terms of risk. And that to me is what insurance is. Tell me what insurance plans were like 20 years ago, just generally, and then what they’re like today. It seems to me to be a very different entity.
Matt Eyles: It is a very different model. So insurance protects against catastrophic risks.
Bill Frist: That’s what I tried to say.
Matt Eyles: And there are plenty of risks that we all face in healthcare, and it’s important to be protected against those. I’d say the evolution in health insurance has really been from insurance and protecting against financial risk, that’s still a part, but to providing coverage and making sure that people have access to care. The health insurance industry two decades ago was much more about paying claims, collecting premiums, not managing care as much. HMOs were really just starting to take off, which are types of managed care plans.
Matt Eyles: Today, health plans are much more sophisticated, and really trying to think about the total cost of care. How do we keep people out of the hospital? How do we make sure that they’re getting preventative care and treatment and services? And really thinking about the whole person, including non-health factors, so where you live, what you eat, do you have access to get to the doctor with good transportation. Really thinking about the whole person ina way that didn’t exist, I’d say, two decades ago.
Bill Frist: Go just a little bit deeper with me. Why is that? Because you’re in the insurance business, and to be in the business and have it sustainable you have to make a profit or a surplus, whether you’re a non-profit or not. And why would it change? Why, from an insurance model, I think of car insurance for example, what you described is very different. Why did it evolve much more to be this patient centered, more holistic view? What’s in it for the insurance company?
Matt Eyles: Right. I think it’s really about taking care of people and recognizing that by meeting people where they are to improve their health, recognizing what health conditions they have today and how do you prevent them from getting worse over time. Or how do you maintain a healthy individual? You need to make investments up front and you need to make sure that people are getting the care that they need on a regular basis, whether it be with respect to primary care. Or if you have a chronic condition, how do you manage it in a very effective way.
Matt Eyles: Because, the downstream implications of not taking care of that, and you know this better than anyone as a physician, can be catastrophic. It can mean surgery, it can mean being debilitated and permanently disables. So it’s really important to invest in those activities up front, and health insurance plans really are at the forefront of recognizing that we need to focus on prevention, wellness, and making sure people have coverage.
Bill Frist: I see that. I see that in my own life all the time, because I’m around a lot of the payers or insurance companies or plans. The why is there, I mean it’s the right thing to do. But insurance companies, I was taught 10, 20 years ago in my economics classes, that healthcare insurance worked by seeing what the claims were from last year or two years before, pulling them all together, having smart actuaries in the room, of course, and then whatever that is, add whatever profit you need for administration on top, maybe 4%, maybe 3% or 2%. And then that would be the premiums for the next year. Now that’s what I was taught, how does it really work?
Matt Eyles: Right. So what you were taught is not incorrect. There’s an element to that and you need smart actuaries to understand what your experience is as a health plan so that you can price appropriately for premiums. What that doesn’t account for are all of the investments in terms of care coordination, medical management, how do you ensure people are getting the care that they need and the types of programs and services that you need to invest in to help either reduce costs for certain populations, mitigate increased costs over time, and hopefully get to a better, higher quality outcome. But the actuary part is still important. Spreading risk is still important. It’s really what’s inside the health plan, in terms of how they think, how they operate, how they try and leverage data, right, technology. Think about the data analytics now that we’re able to employ today versus 20 years ago.
Bill Frist: Just didn’t have it. Didn’t have it.
Matt Eyles: You didn’t know how particular chronic conditions might be connected or not connected, or the fact that people who have diabetes have higher incidence of depression. And how can you then develop programs and services that, again, meet patients and consumers where they are based on their own health circumstances, and hopefully get to a better outcome. But you still need those actuaries.
Bill Frist: Yeah. Exactly, because it’s insurance. It’s much more consumer friendly today than it used to be. We were talking a little bit ago about when I was in the senate and right before I got in the senate the … what was the name of the movie? As Good as it Gets. And HMO, the word was mentioned and everybody in the theaters would go, “Wow.” The world’s just totally different now, totally different now and that focus on the consumer, on the beneficiary, on the patient is really alive.
Bill Frist: But let’s run through some issues that are current issues. Because you, in some shape or form, get involved in all of these. Let’s pick one that’s very topical one, and will be, I would think, over the coming months and maybe years. And that is surprise medical billing. I’m on the board, or have been on the board of the Kaiser Family Foundation, and they started with their series of articles on surprise bills about three years ago. And it seems all of a sudden that has become a huge issue which is where it is. So what is the surprise billing, and then as an association how are you or some of the plans addressing it?
Matt Eyles: Great. So a surprise bill or surprise medical bill is really, at least the way we define it, is when a patient goes into a facility like a hospital that might be part of their insurance network. So they know, for example, if they go to that particular hospital in their community that their insurance plan is going to cover the care that they get. But when they go into that hospital they get treated by certain medical professionals, and it tends to be limited to a certain number of medical specialties such as anesthesiologists, radiologists, and a couple of others, that the patient might not even remember having seen. But then they get hit with a bill by that provider, or from that provider, because that provider does not participate in their health plan network. Again, it might be a physician they never saw, they don’t remember seeing, but then they get surprised with a medical bill. And it can be very staggering at times, as we’ve seen from some of the reports in the media.
Bill Frist: And is it most of it with acute care coming in the hospital unexpected? Or is it most of it planned care where if there was the right focus on it you could figure out how much it was going to be?
Matt Eyles: Right. Most of it is through those acute episodes where someone walks in the front door of a hospital unplanned. I don’t want to say it never happens with respect to planned procedures. So a knee replacement surgery, right, you can do a lot of planning up front, you can ask the right questions. But if there’s an acute episode and you need to get to the hospital to get some treatment, that tends to be where the bigger part of the problem is. We have data that says one in six Americans has been hit by a surprise medical bill. But it is worse in some parts of the country than others. It really depends on whether or not there are adequate physician groups who are participating in health plan networks in the hospital.
Bill Frist: So it seems to me, and we can talk to some of the potential solutions, it’s not really the plan itself causing it, but the plan is a product of it because the plan is giving the coverage itself. And there’s certain people that are not going to be in the network. And when you look at it, what solutions are being talked about? What sort of solutions does the association actually propose?
Matt Eyles: Sure. We have been focused on, first, taking the consumer patient out of the middle. Someone that goes into a hospital and they know that it’s part of their health plan network just should be taken out. So let’s start with that point. By way of solutions though, we think it’s important to come up with a market based benchmark or standard to be able to compensate and pay physicians to make sure that it’s based on something that actually is in reality, a market based charge not something that might just be made up and doesn’t have any connection to what the actual costs or what’s happening in the marketplace. So we’ve supported a market based benchmark.
Matt Eyles: There’s another approach out there that we have not supported, which is around arbitration, sometimes referred to baseball style arbitration where you throw in a number and then you let someone else decide. Now in a healthcare context where you have tens of thousands, and potentially even millions of insurance claims working its way into a system that way over time, we think that that would just add administrative expense. And there are some good estimates out there that that approach would also increase costs over time.
Bill Frist: Take your AHIP hat off for just one second and give me a feel on the arbitration side versus the market based standard, is it about 50/50 in terms of support today?
Matt Eyles: I’d like to think it’s a little stronger in favor of the market based approach. We’ve seen action from the senate through the health committee that supported a market based benchmark. We saw action from the House Energy and Commerce Committee that also supported that. And the administration actually has been supportive of that. But, that said, there’s been a lot of resistance, I think, from some groups out there to going down that path. But I’d like to think that overall it leans towards some sort of solution that involves a market based benchmark.
Bill Frist: Yeah. It’s a good issue in the sense it’s not a partisan issue. I mean it really isn’t, whether democrat or republican. And this town … And I get to go back to Nashville in just a little bit. Which I always love coming here, but also leaving. It’s nice to not have partisan issues to address. But that’s a serious debate, and a very legitimate rational debate to have. And when we talk about surprise billing it very quickly brings up transparency. And we know that healthcare, as delivered historically from the physician standpoint, from the hospital/clinic standpoint, from the plan standpoint, has not been transparent in the past.
Bill Frist: You mentioned markets. For markets truly to work, and in healthcare it’s just more difficult, more complex than other financial institutions in other area. But for the markets really to work you have to have some transparency because you have to have a willing seller and a willing buyer, in classic economic terms. And if you don’t know what you’re buying or how much it costs, obviously markets are not going to work. So let’s go to issue number two, price transparency. Where are we today? Does the plan have any specific proposals? And you can really start with anywhere, the rich plan, a consumer, or hospital.
Matt Eyles: Right. So healthcare is confusing, and we all know that it’s also a classic experience good. You know the quality, actually you experience it. And it’s really hard to shop for it ahead of time, because sometimes you don’t know when you’re going to need it. But with respect to price transparency, it’s really important that consumers, patients, have actionable specific information to their own circumstance, whether it’s their family member, their child, someone else that they care for, to know what it is that it’s going to cost if they do procedure X versus procedure Y. They go to this hospital, versus that outpatient facility. And also specific to their insurance coverage.
Matt Eyles: So we think it’s very important that patients and consumers have access to real-time, actionable information based on their circumstances. And our health plans have invested a lot by the way of resources in terms of making sure that these tools are available to consumers, on their smart phone, online, so that they can know what it is in real-time. Here’s the problem, consumers aren’t using them to a great extent. And we need to do a better job of making sure that they know that they’re available and out there. Because a lot of them work very, very well and can give you important information to know exactly how much you’re going to pay for different treatments and services, or at least very good estimates.
Bill Frist: Yeah. And I think you’re right, it doesn’t bother me the lack of engagement in the broadest sense. Because if you have 100 people, and the fact that all 100 aren’t using the app that gives you price comparisons. But if you have three or four smart people out there using it very accurately it does drive the whole system. So I agree, you want people to be using these, but just getting the prices out there, and a few smart people can drive the system itself. Is there an underbelly to the price transparency?
Matt Eyles: The challenges we see are when you’re putting out competitive information out there for the entire market to see so that your competitors might know what your rates are. And we think over time, and there’s good evidence from other sectors and other industries, and the Federal Trade Commission also agrees that too much transparency around prices for competitors to see in healthcare will probably increase costs. And that’s what we don’t want to see. Healthcare costs are already too high, we don’t want to see them go further higher.
Bill Frist: And now a quick word from our sponsors that make this podcast possible.
Bill Frist: For 35 years MEDHOST has been partnering with community hospitals and specialty healthcare facilities to focus on what matters most, effectively taking care of their patients. Trusted by over 1,000 healthcare facilities, MEDHOST offers a full suite of healthcare IT and business solutions, including an EHR in emergency department information system. Healthcare providers need a partner who can help them meet patient needs with agility. Backed by world class support, MEDHOST solutions are an ideal match for facilities wanting to enhance patient care. To learn more go to medhost.com. And now back to the episode.
Bill Frist: A Second Opinion focuses on this nexus between health and healthcare, and policy. And I think our listeners are sensing a little bit of how important policy is to make markets work in healthcare. And then the third area we focus on is innovation. I think if you put all that together, I think you’ll recognize that price transparency is good, but it may take certain policy to put the larger framework around it to make sure it doesn’t get out of kilter.
Bill Frist: It’s all new though. Nobody talked about price transparency. I was here a long time ago now, 12 years ago, but I’ve been involved with the policy field. And until three years ago people just didn’t talk about it. A few economists did, but a few didn’t. What changed all of that?
Matt Eyles: I think the technology that we see in other parts of our life, and knowing you can find out exactly how much something costs at any point in time. Here in the United States the growth of Amazon and other services, and just the utilization of smart phones and an expectation from consumers that they can find information at the tip of their fingers about so many different elements, it’s forced a lot of people to say, “Well why not healthcare?” And I think the answer is, yes it should be healthcare. The question is, how quickly can we get there and can we put together a policy framework that really does so to enable consumers/patients to have that information that works for physicians as well and gets to the best outcome. And we’re still struggling with that in healthcare. We’re behind.
Bill Frist: It’s coming fast. And I think that’s the message that first there’s a focus on it. And the Trump administration, and Secretary Azar, SEMA, MIRMA, they’re all out there on it. And it’s important for the government to be visible. I think it’s the private sector, which your plans and the providers that are really responding to it. It’s going to be tough here for a while because prices. What are prices, versus actually cost or spending. They’re all very different things, but at least it gets people in the arena.
Bill Frist: If you’re going to be a shopper you need to be a prudent shopper to have an impact, and for markets to work. So I’m a huge advocate, I understand how tough it is. The posted prices aren’t necessarily even what you’re going to pay. And that comes a little bit in the surprise billing, but it also comes into the fact we have rebates, we have brokers, we have middle people. But the fact that we’re even talking about it is a huge step.
Bill Frist: Let’s move to a third issue, and they kind of are coming in my own mind kind of sequential. The political narrative three years ago did not mention Medicare for all, really didn’t mention it. There were other words used, but the whole idea … And Bernie, obviously Bernie Sanders has done a good job in terms of making the case, putting the flag in the ground. It means lots of different things to lots of different people. But here we are in Washington D.C., Medicare for all is part of the political narrative, not just in these next elections, but will be I think for the next three or four years. Where do you start with that? Does AHIP have a position on it? Let’s start unwinding it a little bit.
Matt Eyles: Sure. It’s a complicated issue. And Medicare for all is a very pithy slogan, actually, for a concept that doesn’t necessarily have a lot of detail behind it. But it sounds good, people like Medicare, sure let’s have Medicare for all. But when you dig beneath the surface and start asking questions about, does that mean I will lose my employer plan? Does that mean that if I’m a Medicare beneficiary everyone’s going to be coming into my program now? What’s it going to mean for physicians? What’s it going to mean for hospitals? There’s a lot of questions and not a lot of detail. And it sounds on the surface like an attractive idea, but really when you dit into it, it’s very problematic.
Matt Eyles: When we think about Medicare for all we’re really concerned about really undermining the private sector, the innovation that we’re seeing in healthcare. I don’t really believe that you’re going to see the types of technological investments, whether it be in tele-health, data analytics, all of the things that are really helping to improve health and healthcare, if we’re going to have a government driven, government run, mandated system. So we have lots of concerns about what Medicare for all is, how it would evolve, and a lot of different other variants that might sound a little bit different, but probably take us down the same path, which is something like a public option. Option sounds great, people love choices. But you can design it in such a way that it would undermine and destroy the public market over time, and the innovation that I think that we all want and need.
Bill Frist: In the Medicare for all … coming back to the basics or the Bernie Sanders approach. That literally … I’m asking. I’m going to make a statement, you tell me whether I’m right or wrong. That literally takes 160 million people who have health insurance through your plans and it basically says no longer can you get that health insurance through those plans. Is that what Medicare for all-
Matt Eyles: It’s probably even more than that, because it would undermine both the commercial marketplace, and people who get coverage through their employer, but also, for example, people who get coverage through Medicaid and in Medicaid managed care plans. And there are some of the more innovative parts of the healthcare system to really get to these vulnerable populations and put them all into a government driven Medicare program. And when you think about it, people want healthcare that’s designed for them, to meet them where they are given their life circumstances. And that’s why we have a commercial employer market. It’s why we have a Medicare program. It’s why we have a Medicaid program.
Matt Eyles: And we think we should fix those programs, make them work better, make sure that people have access to coverage, protect against pre-existing conditions, and get the care that they need, but build on what we know that works, not undermine the entire system.
Bill Frist: Yeah, but people … I’m in a lot of debates with comparing United States healthcare system sector to other countries, and statistically how long people live, and infant mortality, how much coverage. And people just forget how heterogeneous the United States of America is. And that origineity is socio-economic, it’s Appalachia versus New York City, the diversity. Where most of the other, not most, but many of the other nations don’t have that, that heterogeneity. That being the case, it’s nice having a system. It’s kind of messy, but to have the diverse system that we have today, that diversity does reflect, I think in many ways, of addressing the heterogeneity to address vulnerable populations or disadvantaged populations or populations in rural versus urban America.
Bill Frist: We talked about pricing, and I guess sort of a final big issue that I’d love to hear your thoughts on is the drug pricing. It’s really interesting … and these statistics I want you to correct me on. Your plans, in terms of profits or surplus, and there’s for profit and non-profit, but surplus today. Plans are about 2-3%. And people say, “Well that may be too much or too little.” But overall hospitals, the 4,000 or so hospitals, the profit or surplus is about 8.8%. People say, “How could that be, because my hospital’s going to out of business?” And there’s all sorts of reasons for that. But on average the last 15 years, 8.8% profit a year. Is that too much or too little, we don’t need to talk about that.
Bill Frist: Drug spending, which we’re going to come to, is 23%, again over the last 15 years, profit. And medical devices are somewhere between 20% and 30%. Doctors, it’s just hard to gather. So, A, it’s interesting because I really wasn’t aware that plans are the lowest of all the entities that I just said in terms of the profits coming in. The drugs are 23%, and again it’s not all easy to explain. But drug pricing today is going to be addressed. It should be addressed in some way because it can’t be sustained over time, it’s going to eat up the whole healthcare budget. Right now it’s not that much of the budget, maybe 20%, in terms of overall spending.
Bill Frist: But what’s happening both in Washington, and again, position from the plans that you represent.
Matt Eyles: Well Senator your statistics are pretty good, because our profit margins as an industry are in that low single digit range, which is 2%, 3%, 4%, that’s absolutely right. And the other sectors tend to be 2, 3, 10 times more than the others. And where we see the real problem with drug prices, and I worked in the pharmaceutical industry for a number of years, it’s really with respect to the practices that we’ve seen over the past decade with respect to the launch price, so what’s the price when the product is first introduced. And then what happens with price over time.
Matt Eyles: And pharmaceuticals, as an industry, is one of the few sectors of the economy where for the same old product, year after year, you’re able to increase price by a significant amount. We’ve seen that increase over time. There are products, and great products, to treat, for example Rheumatoid Arthritis out there that we see advertised on television a lot. When they were launched, they were about 10, 12, $15,000 at the time, and that’s about two decades ago. So very high prices for the time. Same product today is about $50,000 or $60,000. And that kind of price increase that we’ve seen just cannot be sustained by our healthcare system and be able to afford all the things that we need to for patients.
Matt Eyles: So we’re focused on a couple of areas. One, increasing competition. We think competition is a great way to ensure that prices come down over time. Making sure companies can’t extend drug patents in perpetuity like a couple of the companies have tried to do, push them out for decades at a time. The second is really providing more transparency. And we talked about this already, how much does it cost to make that new treatment? Some of the orphan drugs now, right, amazing drugs treating rare diseases, are being approved with very small patient populations in clinical trials, just because there aren’t a lot of patients. Is it costing as much to develop those drugs as perhaps a treatment to cure diabetes if you had to do a clinical trial that had tens of thousands of individuals in it? So we think some reporting on really how did manufacturers come up with that price? Why are you increasing price over time? And other distortions in the system.
Matt Eyles: And then finally, paying for value. We want to pay for what works. If a drug’s going to cost a quarter of a million dollars we want to make sure it’s going to work before we’re going to pay for it. And we think paying for value, and there’s a lot of innovation that’s happening in the pay for value space, and those were a couple of areas where we need to really find solutions to make sure over time we can get the price down.
Bill Frist: And is there, for something like an aortic valve, and I’m going to use the devices. An aortic valve will cost 10 times, in this country … Aortic valve in which you put in the heart, which I used to put in the heart, costs 10 times what it does in a country 2,000 miles away. And drugs is exactly the same, where other countries it’s on the marginal cost, and we’re paying a much higher cost, allegedly, for research. But we are doing the world’s research there. Does that enter into it? As a society should we be doing the world’s research? And how much should we pay for it?
Matt Eyles: It’s a great question, and we do see that phenomenon where really prices … and the U.S has a price problem much more than a quantity problem. In that for the same treatments, drugs, services, devices, we’re paying many times more than other countries are. Is that fair? We should probably have a conversation about what would be fair to ensure that the United States remains an engine of innovation, but isn’t disproportionately sharing too much by way of paying for it. We do a lot of basic research through NIH, as you know, that then gets translated and commercialized by pharmaceutical companies.
Matt Eyles: And the question is, are tax payers getting a good return on their investment for all of the basic research that we’re doing? And do we need to rethink the balance? And what is an appropriate amount of profit, based on the risk that a company might take on, especially if they’re really bringing products into the portfolio rather than doing the clinical research themselves. So, very complicated questions, but it’s an issue that we need to grapple with.
Bill Frist: The whole pricing issue. I’m on the health affairs, the journal has put together a council that’s looking at prices and value over the next three years. And it’s been fascinating to me what drives prices, what drives prices up, the fact prices are not cost. Prices in America are just higher than other countries for the same product. The drug is a little bit different because the pharmaceutical companies and the PBMs and the brokers and all are just selling them to other countries less. So it’s a separate issue than just we charge more in this country. So I love the fact that you’re addressing it.
Bill Frist: Let me turn to a couple of quick questions, and one’s more personal, and that has to do with you. And your history, I already described earlier, but is really a fascinating history. And now you’re running this organization that represents the plans through which more than half of America gets their insurance. Was there a pivotal moment in your career, just looking back, that you can share that either put you on a trajectory to where you are today, or in some way influenced your direction in health or healthcare?
Matt Eyles: What a question. I’ll have to make this one a little bit personal. So my father passed away suddenly at age 60 back when I was still early in my career. I was about 30 years old. My wife was pregnant with our son. And it really made me stop, in many ways as the death of a family member will, to really think about what’s important, where do you want to go with your life and how do you want to make a difference. And I had just started in the pharmaceutical industry at that time, and was really learning a lot more about health. And really triggered something in me to say, “I want to do something where I think I can make a difference to people over time and focus on making sure people have coverage, making sure people have access to care, making sure that we’re doing all the things that we can to protect and improve health,” because it can be taken away from you in such a brief moment.
Matt Eyles: So I really wanted to dig into what I felt passionately about, healthcare, and finding ways to hopefully improve our healthcare system for many, many more people. But it really did make me stop and think about what do I want to do going forward.
Bill Frist: You’ve kind of answered my next question, but in life when younger people ask me or people my age even ask me what should you do next, it really does come down to do a good job in a great career, but if you can link that to something that you feel passionate about, something where you are making the world a better place. And it’s one of the great things about healthcare, and you clearly have done that and you manifest that every day in your current position.
Bill Frist: If somebody said, “I want to go into healthcare,” because you’ve done the consulting, the analytics, the pharmaceutical part, if somebody came up or if somebody’s listening to us right now and say they’re 25 years old and say, “You know, I do want to go to health and to healthcare and devote my life to it.” What advice do you give them, just in career advice?
Matt Eyles: I would say follow your passion, senator. And if you feel strongly about it don’t let anything stand in your way if you want to make a difference. Now of course if you want to treat patients you probably need to go to medical school, that’s sort of a prerequisite. But if you want to do innovative things in healthcare, to make a difference, that degree is not necessarily prerequisite to being successful. It’s finding what you care about, being creative, being flexible, and following what you believe in.
Bill Frist: Yeah. We’ve talked about so many things that are really useful to me as I learn more and more, which I do every day. If you did have a magic wand, given all the things you see, because in your position you see all of the problems, you see all the policies here in Washington D.C. that are proposed. You see what’s organic, what’s on the ground because you’re talking to your plans and your beneficiaries every day. If you’d had that magic wand, again, there are a million things you could do. Is there one thing that you would say, “Okay, this is where we should go?”
Matt Eyles: Can I get two wishes?
Bill Frist: Yeah, I guess I could.
Matt Eyles: The first one would be to really have a truly interoperable, electronic healthcare system. I think we have been so hamstrung by having a system that’s piecemeal, that doesn’t talk to one another. We’re making a little bit of process, but think about the benefits to our system in terms of outcomes, cost, waste, redundancy. If we had electronic medical records that truly talked to one another, that incorporated health benefit information, that had cost and pricing in it, our system would be so much easier, simpler to navigate, better for patients, easier for physicians, probably less fighting between health plans and physicians over whether things should be covered or not, because you would know. You would have a source of truth that would be there, and people would have much better information.
Matt Eyles: The other thing would just be getting rid of paper entirely in our healthcare system. It seems like there’s no real place for paper in our system. And it slows us down, adds waste and inefficiency, and isn’t generating any value for us.
Bill Frist: Yeah. And those two kind of go hand in hand, though the paper one really does come back to pushing paper, the regulations that require the paper and the like. In closing, are you optimistic? You’ve seen a lot. Are you optimistic or pessimistic?
Matt Eyles: I am optimistic, and maybe optimistic to a fault. But I’d much rather think that we can solve these problems and make progress than be a glass half empty person. So I am optimistic. And when you think about how far our healthcare system has come in the past quarter century, at least that I’ve been working in it. The advances, the developments, we really need to come to cost and affordability. But I’m optimistic that we’re going to make progress and that we can solve these problems.
Bill Frist: As I think back, just even our conversation today, how much is possible to do today versus the past because of the devices we carry around, the parallel computing, the digitization. Then when you start coupling all that computing power with the data that’s out there that you collect as an association, and the data that we can learn from, it really is pretty exciting times.
Matt Eyles: It is.
Bill Frist: Matt, thanks so much.
Matt Eyles: Thank you.
Bill Frist: It’s been a great opportunity for our viewers to listen to your ideas, to hear us talk about these current issues. And look forward to continuing this conversation later.
Matt Eyles: Thank you.
Bill Frist: Thanks a million. Appreciate it.
Bill Frist: This episode of A Second Opinion was produced by Todd Schlosser, The Modus Creative Group, and Snapshot Interactive. You can subscribe to A Second Opinion on Apple Podcast or wherever you’re listening right now. And be sure to rate and review A Second Opinion so we can continue to bring you great content. You can get more information about the show and our guest and sponsors at asecondopinionpodcast.com. That’s one word, asecondopinionpodcast.com.
Bill Frist: Be sure to join us for our next episode with my good friend James Capretta, who was former associate director at The White House Office of Management and Budget, and is someone who I have worked closely with on healthcare policy, both at the Bi-partisan Policy Center and The American Enterprise Institute in Washington D.C.
Bill Frist: A Second Opinion broadcasts from Nashville, Tennessee, the nation’s Silicon Valley of health services, where we engage at the intersection of policy, medicine, and innovation.