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Envision a Payment System With Healthcare That Works For All

IAF Futurist Marsha Rhea Creates New Venture to Lead Change

Fifth DRA Partners Meeting Looks at Scenarios for the Future

Forward Perspectives

Envision a Payment System With Healthcare That Works For All
By IAF President Jonathan Peck

As the presidential campaign continues it is clear that the broken state of our nation's healthcare system will be a primary issue in the general election campaign. One of the most important areas for healthcare reform is our payment system, which has developed over decades without explicit designs intended to improve health outcomes or reward quality.

IAF is tackling the need for a better healthcare payment system as part of its 2019: Healthcare that Works for All project. The first paper on 2019 Payment Systems envisions what success will look like if policy makers start a decade of improved payment policies beginning in 2009.

Change is needed over the next decade to create real incentives to improve care and move away from payment for procedures and services offering lower value. A key component of this change is a government sponsored approach to assessing the value of procedures, therapies and services that takes advantage of a network of healthcare quality researchers. The network will use open source methods to link government funded researchers together to look at the comparative efficacy of healthcare procedures and services. We call this network ONCE (Open Source Network for Comparative Efficacy).

The healthcare payment system of the future must balance access to high-quality affordable healthcare system for all Americans with restraints based on purchasing value. The value will be defined through the ONCE network and would inform reimbursement decisions. Payments will be made through fee schedules that constrain excessive profits.

There is a clear cost for continuing with our broken system for healthcare payments. The worst outcome is a decline in America's health. Not only can physical health deteriorate, so too can economic and psychological health as insecurity grows thanks to an insurance system, including Medicare, which is heading into crisis.

At its worst, even the spiritual health of America is diminished by a future where the rich take care of themselves, but the poor are mired in hopelessness while the middle class worries and looks for care outside the mainstream of American medicine.

The 2019 Project acknowledges this fear of failure while it focuses on how to achieve a much better future for health care. Through the 2019 Project, IAF is offering a clear set of principles that can guide policy so that health care authentically works for all rather than just the few. We invite readers to question whether the payment system we envision can work and give this country the right combination of free-market with effective governance so that health care improves our health. The paper on 2019 Payment Systems in Healthcare that Works for All is now ready for review and comment.

News and Events

IAF Futurist Marsha Rhea Creates New Venture to Lead Change

IAF is pleased to announce a new collaboration with Signature i, a new venture launched by Senior Futurist Marsha Rhea, to help organizations lead the changes that are necessary to achieve their vision.

In working primarily with IAF's nonprofit and government clients for eight years, Rhea recognized that many organizations need the extra momentum and coaching that an external change agent can offer. Signature i will help organizations define their strategic issues, plan signature initiatives, align their organizational identity with their vision and goals, and innovate new programs and services.

"I've often ended speeches or workshops with the advice that a vision is only a dream without the commitment to act," Rhea said. "I decided it was time to turn this insight into a new business that could build on the potential of great futures work."

"We recognize the value of Marsha's focus on the near-term changes that organizations need to make in order to create the future they want," said Jonathan Peck, IAF President. "We look forward to combining the IAF strength in futures with the assistance Signature i offers those who manage organizational change processes. IAF looks to grow this and other capabilities through a network of collaborators such as Marsha, who we know is extraordinarily good at change leadership."

Rhea came to IAF with more than 20 years experience as an association executive and holds the certified association executive (CAE) designation. She has led IAF projects for associations and nonprofits such as the National Association of Elementary School Principals, ASME (mechanical engineers), Southern Association of Orthodontists, American Occupational Therapy Association, Safe Kids Worldwide and American Industrial Hygiene Association.
She has given speeches and led workshops for many more associations. Her government projects have included the U.S. Forest Service Eastern Region, Centers for Disease Control and the National Heart Lung Blood Institute. Rhea will continue to work as a futurist with IAF on selected futures projects where her knowledge, facilitation, and project management can contribute to the project's success.

"IAF has the team to do great futures work. Signature i will recommend that expertise when we discover clients who need futures research and proven processes to understand their preferred future," Rhea said. "The institute has a body of knowledge, methods and experience that Signature i values as part of its network."

"In its 31 years as an institute, IAF has introduced many people to aspirational futures--they came to us as interns and employees and went on to other careers and organizations with a strong sense of the difference that a powerful vision contributes to our shared future," said Clem Bezold, IAF Chairman and Founder. "Our vision commits us to working to create a network of leaders who can be more strategic in their decision making. We are proud that Marsha will be taking this wisdom to leaders in a new way."

Fifth DRA Partner Meeting Looks At Scenarios for the Future

In a time of economic uncertainty and rising inflation there is a greater need than ever to focus on health inequities. The DRA Project is addressing these uncertainties by creating four scenarios on the future that directly look at health inequities.

The scenarios were a key part of the fifth DRA Project Partners meeting in Alexandria, VA. Representatives from the DRA Project Partner network met on March 31st to discuss the future of health inequities and advances to reduce those disparities. In the meeting discussion the DRA Partners talked about the perils facing underserved communities over the next 20 years. However, the partner's meeting also showed the opportunities for creating a more fair and equitable society if we change our minds and our hearts to serve the least among us.

The Gaps Grows

Despite goals and programs to "eliminate health disparities" and universal access to effective health care, health disparities increase in the US over the next two decades. Health care access and quality improves, but the more significant social determinants of health and disparities are not dealt with.

Depression, Disasters and Self Protection

It's a dark time in America over the next twenty years. Many things can and did go wrong. The worst economic conditions in 80 years, peak oil, climate change, and recurring natural disasters lead to an inward focus (me and my family first). Health care worsens and health disparities increase. Low-income and minority populations are disproportionately affected.

Sharing the Burden

The response to the Great Depression of the early 21st Century and a range of natural and manmade challenges parallel the response to the Great Depression of the 1930's. More personal and family caring and more effective economic and social programs focused on the social determinants of health reduce health disparities over the next two decades. More frugal and effective health care led by community health centers adds its contribution to reducing disparities.

The Mind and Heart Shift: How to do Something About It

Society changes its mind. It did so with slavery, segregation and women's rights. In the first part of the 21st Century, society changed its mind on equity or fairness, including health equity. Disparities that are avoidable are no longer looked at as normal. Jobs, living wages, affordable housing, education, access to healthy foods, and safe and activity-friendly neighborhoods become goals for local, state, and federal policy. Health care plays its role, anticipating patient needs, being patient centered, lowering costs, and leveraging the social determinants of health.

The meeting also discussed successes from the previous year and priorities for 2008. Some of the other topics discussed include the first briefing on reducing health disparities on Capitol Hill, new advances in biomonitoring and their impact on reducing health disparities, an expanded model for care, and health equity movements that the DRA Project and partners are involved in.

IAF is inviting the comments of its DRA Partners and its newsletter readers to help illuminate the perils and pitfalls the underserved face in the future. To register your comments and opinions on the scenarios or to find out how your organization can join the DRA Project contact Craig Bettles at cbettles@altfutures.com. The final scenarios will be announced in this newsletter and released on the new DRA Project website.

WorldFuture Conference Approaches

The annual conference for the World Futures Society, WorldFuture 2008: Seeing the Future Through New Eyes, will be held in Washington D.C. this July. This year's program features prominent futurists speaking on a wide range of issues. We encourage our readers to attend this unique experience. IAF will be speaking on a number of key issues this year.

Wiser Futures Workshop: The Institute for Alternative Futures will be holding a workshop introducing its world-class approach to aspirational futures techniques in communities, organizations, governments, and corporations. The workshop will be led by IAF Futurists Clem Bezold, Craig Bettles and Devin Fidler. This full-day pre-conference course will be held on July 26th, 2008.
Health For All and a Health Care System Worth Creating: IAF Founder Clem Bezold and Senior Futurist Bill Rowley will discuss the exciting opportunities for the future of health care and will demonstrate the Institute for Alternative Future's (IAF) model for a health care system worth creating in this session. The session runs an hour and a half and will be held on July 27th, 2008.
Using Futures in Organizational Strategy: When futures work is applied deliberately, futures work contributes to organizational strategy and encourages a coordinated approach to achieving defined objectives. IAF futurists Jonathan Peck, Bill Rowley and Devin Fidler will discuss their experiences and methodologies in using futures to craft business, nonprofit and association strategies from a number of different perspectives. This special hour and a half session will be held on July 27th, 2008.
The Coming Decade in Air Travel, 2020 Visions from Two Blind Seers: IAF Senior Associate Jay Herson and David Pearce Snyder of The Snyder Family Enterprise discuss air travel from the perspectives of a technology forecaster and a trend extrapolator. Through a dialogue with the audience, the two futurists will show how two dramatically different future visions of air travel to create a complete picture of air travel in 2020. This hour and a half session will be held on July 27th, 2008.
2021 Vision for Elementary and Middle Schools in a Global Society: The National Association of Elementary School Principals (NAESP) recently studied provocative changes that lay ahead for schools and principals in a wide ranging futures and vision project with IAF. They have used their analysis to shape a 2021 vision for the profession. Elizabeth Carlson from NAESP joins Marsha Rhea and Craig Bettles from IAF to discuss the major findings of the project. The session will feature a vision exercise for the participants. This hour and a half session will be held on July 28th, 2008.
Key Trends and Uncertainties, Views from Corporate Foresight: Global companies face more important trends and uncertainties than ever before. Global warming and the responses to it, peak oil, nanotechnology, economic challenges, the decline of the U.S. dollar, the changing role of the U.S., terrorism, social and political trends toward greater equity, aging, and the rise of living in virtual reality are among a few. This special session tackles these trends and uncertainties from a corporate and global perspective. Panelists include Clem Bezold, IAF Founder and Chairman of the Board, Klaus Heinzelbecker, Director of Strategic Projects at BASF AG and Gereon Uerz, Senior foresight Consultant at Z_punkt GmbH. This hour and a half session will be held on July 28th, 2008.

We here at IAF look forward to meeting you at WorldFuture 2008. You can register at here at the conference website. Look in the Upcoming Events section for the dates of our upcoming events.

Upcoming Events

Keynote Address, Toycon: Play in the Digital World, IAF President Jonathan Peck, May 2nd, Phoenix, AZ.

Wiser Futures Workshop, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Futurists Clem Bezold, Craig Bettles and Devin Fidler, July 26th, Washington, DC.

Health For All and a Health Care System Worth Creating, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Futurists Clem Bezold and Bill Rowley, July 27th, Washington, DC.

Using Futures in Organizational Strategy, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Futurists Jonathan Peck, Bill Rowley and Devin Fidler, July 27th, Washington, DC.

The Coming Decade in Air Travel, 2020 Visions from Two Blind Seers, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Senior Associate Jay Herson with David Pearce Synder, July 27th, Washington, DC.

2021 Vision for Elementary and Middle Schools in a Global Society, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Futurists Marsha Rhea and Craig Bettles with Elizabeth Carlson, July 28th, Washington, DC.

Key Trends and Uncertainties, Views from Corporate Foresight, WorldFuture 2008: Seeing the Future Through New Eyes, IAF Founder and Chairman of the Board Clem Bezold with Klaus Heinzelbecker and Gereon Uerz, July 28th, Washington, DC.