This mild-mannered CEO in Massachusetts feels a personal stake in the success of the Patient Protection and Affordable Care Act, and he's not from a health system.
A profile on Andrew Dreyfus, president and CEO of Blue Cross Blue Shield of Massachusetts, in The Boston Globe dubs him as "the last healthcare reform optimist." He's certain medical costs can be reigned in, care can be less expensive to consumers, and this can all be accomplished in a way that pleases both political parties.
Mr. Dreyfus got in the limelight in 2009 when he helped launch a BCBS payment plan dubbed "alternative quality contract," a modified global payment model or the insurer's version of an accountable care organization, essentially. It rewards providers that keep patients healthy and cut down on unnecessary medical procedures and gives providers fixed budgets for treating patients rather than paying by volume. If the providers come in under budget, they make more money.
"A lot of plans are borrowing from that playbook," Karen Ignagni, president of America's Health Insurance Plans, said in the report. And it's because of that, she says, Mr. Dreyfus has "become an important go-to person throughout the industry."
Four months after becoming CEO in 2011, Mr. Dreyfus sent a letter to more than 400 hospital and medical group leaders, urging them to switch to risk-based contracts with fixed budgets. The document became known as the "or else letter." Today, about 85 percent of BCBS HMO members are treated by doctors and hospitals that work under the alternative contract, up from 32 percent in 2010.
This is one of the reasons cited for slower premium increases than seen in prior years. BCBS of Massachusetts signed up more members than it lost for the first time in five years last year, even through profits fell from $164 million in 2012 to $69 million. The insurer attributed the drop to new taxes and fees, technology outlays and efforts to hold down premiums.
Mr. Dreyfus' influence in Massachusetts (Gov. Deval Patrick says he turns to Mr. Dreyfus for advice on healthcare issues) is now spreading to Capitol Hill. In recent weeks, the CEO has huddled in with lawmakers Washington, Republicans and Democrats alike.
His supporters say he has the ability to excite seasoned healthcare experts who might feel like they've heard it all. Princeton professor and economist Uwe Reinhardt, PhD, recalls when he heard Mr. Dreyfus explain the alternative quality contract model in a seminar. "I've been to a thousand health care conferences," Dr. Reinhardt said in the report. "People talk about innovations when they're recycling ideas that didn't work before and they think they can make them work now. When I heard Andrew, I was electrified."
The article closes with some quotes from Mr. Dreyfus as he spoke in a seminar at the Wharton School of the University of Pennsylvania. Here's an excerpt:
"The Affordable Care Act anticipated a national solution to health care," he says, but he admits that now it may take time — and experimentation — to reach any kind of nationwide consensus. "We might wind up with five variations, and that might not be a bad thing."
His talk soon veers back to Massachusetts and the example it offers. The state's "lessons are transferable," he insists. But for the nation as a whole, he says, "it's going to take a decade, and we should give it a decade."
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