AHA Chair Tells Utah Leaders: Reform is for Each Community

The American Hospital Association's chairman told Utah community leaders that while the broad healthcare landscape is changing dramatically; individual communities will have a huge role in determining how well healthcare is delivered locally.

Richard P. de Filippi, chairman of the American Hospital Association, described the healthcare environment before and after health reform takes effect and said everyone has a role to play in making the best parts of it work. His presentation was part of a Healthy Dialogues lecture series sponsored by Intermountain Healthcare in May. The series brings national experts to Utah to help address local solutions to the challenges facing America's healthcare system.

Key issues facing the current healthcare environment

Here are some of the major issues plaguing the current healthcare system, according to de Filippi:

  • Concerns about the quality of care provided
  • Overutilization/perverse incentives, including pay for volume, not quality
  • Rising costs
  • Poor access

Some main aspects of the health reform law passed this year

  • Health insurance coverage for an estimated 32 million people who are currently uninsured, plus insurance reforms
  • Healthcare delivery system reforms, many with incentives (rather than the directives common today)
  • Hospital Medicare payments: reduction in inflation allowances (though there will be an actual decline in those payments in 2010)
  • Prevention, wellness, and public health funding
  • Quality improvement incentives: increased payments for better- quality care, research, and an increased focus on comparative effectiveness. "You mean to say we've been using procedures that we're not completely sure are the most effective procedures? The answer to that is, I'm afraid, yes. There's not a great deal of systematic data to show what the effectiveness is of a large range of procedures used in both therapy and diagnostically."
  • Safety-net hospital payments to be reduced

Key components in addressing the new healthcare landscape

Broad community involvement and commitment. "To me, this represents one of the most significant things we need to think about in this post-healthcare reform era," de Filippi said.

Why? Here's how the U.S. Department of Health and Human Services breaks down the factors that determine a person's health:

 Lifestyle & Behavior   50% 
 Environment   20% 
 Human Biology   20% 
 Medical Care   10% 


Medical care is at the bottom! So, looking at the bigger factors, de Filippi argued individuals, schools, social services, businesses, the medical community-everyone has a role to play to make the important changes.

To view the slides or to hear the entire presentation, visit:


Past speakers at Intermountain's Healthy Dialogues lectures include former U.S. House of Representatives speaker Newt Gingrich, former Utah governor and U.S. Health & Human Services secretary Michael Leavitt, and Don Berwick, MD, who is President Obama's nominee to head the U.S. Centers for Medicare and Medicaid Services.

"Intermountain is exemplary in its model of its care delivery system, its patient-centeredness, for the integration of the system that exists here."

— Richard de Filippi, Chairman, American Hospital Association

Richard de Filippi, chairman of the AHA, was recently in Salt Lake City and spoke before a packed audience for Healthy Dialogues.