Note: This interview was originally published in the Fall 2016 edition of Williams Mullen On Call.

Williams Mullen recently interviewed Virginia Chamber of Commerce President and CEO Barry DuVal to obtain the Virginia business community’s perspective on the current health care system and health reform.  Mr. DuVal provided the following observations.

This interview has been edited and condensed.

1. What do you see as the biggest achievements and challenges in health care in Virginia during the next two years?

"Our goal at the Virginia Chamber is to use innovation to transform Virginia’s health care system by improving quality, access and cost through technology and consumerism. That will help us transform Virginia’s health care system for the better. One of our objectives is to facilitate the sharing of best practices and innovation within the health care system, particularly with things such as telemedicine and employee wellness.

For example, The Wall Street Journal called the Huntington Ingalls Onsite Health Clinic in Newport News one of the most innovative national examples of business leadership in health care. Its multi-million dollar on-site health clinic provides essentially free health care to 20,000 shipbuilders and their families.  The Motley Fool, headquartered in Alexandria, has a nationally recognized and innovative wellness program that helps them recruit and retain young people.

Those are excellent examples of innovation, technology and investments in health care that we see the business community making, and we would like to see more of that throughout the Commonwealth."

2. What are some health care initiatives that the business community would like to see continued?

"Personal choice and access to health care are where we should be focusing.  Today, some employers, especially small to medium-sized businesses, are moving from what are essentially defined benefit programs to defined contribution programs for health care expenses.

In other words, they are saying to an employee that we are going to invest $4,000 a year in your health care by giving you that money and directing you to an exchange where you can purchase your health care coverage. You can buy whatever program you want. That is consumerism.

We also support initiatives by major health care systems to use technology, innovation and apps to connect with employees and encourage them to focus on preventative care such as annual checkups, oral checkups and so on. They are using innovation and technology without trespassing on HIPAA laws to improve access and outcomes.  It is pretty powerful."

3. What can be most easily accomplished to help the uninsured and small businesses?

"We believe investing in prevention and pursuing high-value treatment of chronic diseases, behavioral health and the special needs population is important, as is improving the value of health care. Anything the health care systems themselves can do to control costs will help small businesses. Small businesses have many of the same challenges as large businesses, but they often lack the resources to achieve cost savings on their own."

4. What trends do you see in provider reimbursement and in premiums?

"We have seen premiums rise more than 20% in the past five years, and that is a burden for businesses. We also recognize, as announced by the Secretary of Health and Human Services last year, that 90% of all traditional Medicare payments are going to be tied to quality or value by 2018. Employers still pay about 70% of workers’ families’ premiums and about 82% of the single-person premiums. We know savings have to occur.

The challenge is that the historic model has not been based upon that formula, but the model going forward will be. The transition is going to be a challenge for the health care systems, the insurance industry and the consumers, but somehow, we have to find a way to get through this transition."

5. Overall, what are you most optimistic and pessimistic about in health care in the coming two years?

"The fiscal debt of the United States has the business community concerned.  One of our top priorities is to see constructive dialogue on fiscal policy.  Changes to the health care system are critical to prudent overall fiscal policy.

I am optimistic about the future because I think the business community is beginning to step up and be heard on these issues. And we are encouraging some practical initiatives around health care on a regional basis.

Health care is a very important part of any business as it relates to personnel and expenses, and I think the new Congress and the new President have to address the overall financial health of America. It was not something you heard a lot about in the recent election, but the fiscal reality will face the new President and the Congress in the next few years."

6. What impacts do you anticipate as a result of the November elections?

"The Virginia Chamber does not endorse candidates. But we do endorse ideas. Both political parties concede that the ACA is broken and needs to be fixed. We just saw it announced that 2017 premiums of health plans sold through healthcare.gov are rising on an average of 25 percent. Both sides recognize that the initial legislation has had significant negative consequences; therefore, I think both parties recognize the need for a change. It’s still too early to really know what the details of the changes will look like, but our hope is that we will find common ground on improvements to health care laws nationally. We need to get a handle on rising costs for businesses and consumers."