An Interview with Catherine Strode
Donna Lynne was sworn in as Colorado’s 49th Lieutenant Governor and Chief Operating Officer on May 12, 2016. Widely respected as an expert in the health field, she was named one of the top 25 women in health care nationally. As former Executive Vice President of Kaiser Foundation Health Plan in Colorado, the Pacific Northwest, and Hawaii, she managed an $8 billion budget, 16,000 employees, and over one million Kaiser Plan members. In an interview with Catherine Strode, Lt. Governor Lynne discussed some of the challenges facing the state and how she will use her expertise to tackle them.
Watch a video of this interview:
How will your career experience impact your role as Lt. Governor?
“What I hope to bring to the state is a renewed focus on teamwork and how much your colleagues are key partners in what you do. I think the second thing I learned in my career at Kaiser is the importance of the customer. The customer in health care is a patient. The customer in the state of Colorado is the taxpayers, the people who try to get services from the state (getting a driver’s license, paying taxes, getting immunization or birth records). They are all important customers. You can’t be successful in health care if you don’t focus on them. Part of what Governor Hickenlooper asked me to do was to think about how we make state government more consumer-centric and how we become more transparent with our customers about how we’re doing.”
Where can transparency in health care be improved?
“Health care suffers from a lack of transparency even more than other businesses. There’s a famous quote that says we spend more time doing research on our washing machines than we do picking our doctors. That’s partly because there isn’t a lot of good information about what’s a good doctor. How do you create those metrics around what a good doctor is and what a good hospital is? The other lack of transparency in health care is around pricing. With more people having high deductible health plans, you want to know what your financial liability is because it can be in the thousands of dollars. Health care has struggled to get that information to consumers. I think the advancements health care is making in technology are going to facilitate that. Also, more health plans are recognizing, ‘I’ve got to give some financial information to my patients because they have to make tradeoffs.”
Why is making health care prices transparent challenging?
“There are challenges around creating transparency on prices because, generally, you fix a price based on what your revenue is and what your problems are. I think a lot of doctors and hospitals don’t want to be measured on these issues because there is so much variation. If you’re serving a lot of patients, your costs overall are going to be a little higher. You have differences in academic medical settings from other settings. I think the other challenge is you often don’t make decisions on prices in health care like you do on a car. I know a car that is moderately priced will get me to work but I can’t afford a high end luxury car. In health care you don’t want to be making those decisions around price. There is definitely some confusion and need for clarity. Does the price that anyone charges imply something about quality? When you’re shopping for a car, it’s much easier to do price comparisons. In health care, it’s much more difficult. Doctors don’t advertise their prices; hospitals don’t advertise their prices. You have to ask yourself, ‘Do I understand the tradeoff between quality and price?’ Does a high price necessarily mean you get quality? Not always.”
How will you work to improve the state’s health care delivery system?
“I think one of the biggest problems that faces the state in health care is a lot of our state budget is consumed by Medicaid. One hundred per cent of the Medicaid expansion was paid for by the federal government; so it (the expansion) doesn’t impact the state’s budget in the way you might think. The cost of care, just the simple increase in the cost of goods and services, for those people who had Medicaid before 2014 does impact the state’s budget. It is a big conversation at the State Capitol because the Medicaid budget continues to grow. Health care costs nationally continue to grow greater than the consumer price index. Counties like Summit County, Pitkin County, Eagle and Garfield Counties, have the highest cost of health care (not just for Medicaid but for their typical commercial population) in the United States. A bill passed this session looking at: can we create a single rating region for the entire state? When a health plan submits its rates for employers or individuals to buy, it does it by geographical region. There are multiple geographical rating regions. One idea would be, let’s create the entire state as one region. That way, you spread the costs across everybody.”
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.