The AHIP Institute for health insurers kicks off later this week, and it's going to be fascinating to see what a difference a year makes. The 2010 show had an undercurrent of cautious optimism over health reform, and the fact that the Obama administration was taking a serious stab at bending the cost curve was widely applauded ... and supported by speakers from the upper echelons of the America's Health Insurance Plans association and the Beltway insiders who gave the keynotes.

But as I had noted during my coverage of last year's show, the speakers who are in the trenches had a somewhat different take on the sharp ends-insurance exchanges, bundled payments, paying for quality, etc.-of health care reform.

Anna Fallieras, program leader for health care initiatives at General Electric, felt it necessary to tell her audience to avoid irrational exuberance over the move to pay physicians for quality over quantity, noting that GE's health care expenditures had shot up 30 percent in 2009 even with a push for paying for quality over quantity.

And Andrew Baskin, M.D., the national medical director of quality and provider performance measurement at Aetna, spoke about how bundled services/payments in theory was great, but in practice was opening a big can of worms, noting that to make bundled payments work requires multi-payer and commercial/CMS collaboratives that provide standard incentives and processes to incentivize providers to make the required investments in I.T. and other areas to support the model. (Baskin will be tackling that same topic during a June 28 Web seminar hosted by HDM.)

I'm interested to see what the takeaways will be from this year's show. I don't expect irrational exuberance, but I do expect some blunt talk about how to salvage aspects of health reform and make some of the programs born from the fevered dreams of our political leaders work in the real world. Stay tuned.


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