Healthcare Complexities Challenge Improvements to Care and Cost Reduction


BIRMINGHAM – Challenges to the three legs of health care were expertly explained by a hospital administrator, a leading health insurance company executive, and a physician at the Business Council of Alabama’s Pathways to Policy Summit on Alabama’s Future.

The summit held Oct. 27-28 at the Hyatt Regency Birmingham – The Wynfrey Hotel included the state’s top leaders in the Legislature, education and workforce development, infrastructure, and health care cost and care management.

Speaking at the summit on Pathways to Improving Health Care and Reducing Costs, sponsored by The Partnership between the BCA and the Chamber of Commerce Association of Alabama, were L. Keith Granger, chief executive officer, Grandview Medical Center; Jeff Ingrum, senior vice president of the Healthcare Networks Division, Blue Cross Blue Shield of Alabama; and Dr. Chad Mathis, a specialist in sports medicine, Alabama Bone and Joint Clinic.


They represent health care’s three legs of support.

BCA Board Member and BCA Health Committee Co-Chair Denson Henry, vice president of Henry Brick Company Inc., moderated the panel discussion.


Granger said, in the final analysis, health care is a service business but a very complicated one involving government regulations, extreme cost pressures and low profit margins, patient expectations, medical needs, and personal choices that affect medical costs and service.

Granger said the debate in the United States is whether health care is a right or a privilege followed by who controls consumption of services – patients, physicians, hospitals, or insurance providers. Then there’s the overarching Affordable Care Act that began affecting health care in 2010.


“Health care is a critical business, and the services we provide are vitally important,” Granger said. “Changing the system is going to be very painful.”

Granger said eight hospitals in Alabama have closed in the last five years, and 69 percent are in the red, signaling that the industry’s finances are in “serious need.”

Granger suggested several options Alabama leaders can explore: Medicare equity because some other states receive 150 percent of the payments from Medicare for identical services in Alabama; end-of-life preparation by families is essential; there’s a “crisis of payment” for substance abuse and psychiatric treatment; and Alabama loses taxes it pays for Medicaid that goes to other states because Alabama has chosen not to expand Medicaid.

The second leg of health care is medical insurance.

Independent Blue Cross Blue Shield companies provide health insurance to more than 100 million people in three dozen states including Alabama. In Alabama, Blue Cross Blue Shield is the dominant insurance company chosen by physicians, hospitals, and consumers.


Ingrum said Blue Cross Blue Shield meets the myriad challenges of health care by working with hospitals, primary care physicians, business, and consumers.

Dr. Mathis said physicians face too much paperwork and regulations that help cause physician shortages.


“We spend too much time doing things that have nothing to do with being a physician,” Dr. Mathis said. “There are solutions, but it’s going to take leadership at the federal level and the business community.”