HSC's 14th Annual Wall Street Comes to Washington Conference

Conference Transcript | July 8, 2009 | Hosted by the Center for Studying Health System Change

The Center for Studying Health System Change held its 14th annual Wall Street Comes to Washington conference, bringing together equity analysts, bond analysts and health policy experts to discuss market developments relevant to health policy. The conference, funded by the Robert Wood Johnson Foundation, was designed to give the Washington health policy community insights into market forces from analysts who tracked publicly traded health care companies and assessed hospital debt repayment prospects.

Panel One: Health Insurance Market Trends

The first panel, moderated by HSC President Paul Ginsburg, featured Christine Arnold of Cowen and Company and Matthew Borsch of Goldman Sachs alongside Joseph Antos of the American Enterprise Institute. The discussion centered on how looming health reform proposals would reshape the insurance industry, particularly the creation of a public plan option, the establishment of insurance exchanges, the impact of an individual mandate and increased regulation. Panelists also addressed Medicare Advantage's future, premium trends, employer wellness and prevention initiatives, and the state of consumer-directed health plans.

Borsch argued that a public plan paying providers at rates close to Medicare would hold a substantial pricing advantage and would likely capture growing market share over time, potentially leading toward a single-payer system. Arnold discussed how insurers were positioning themselves for potential regulatory changes and the competitive dynamics that reform could create in the exchange marketplace.

Panel Two: Hospital and Physician Trends

The second panel brought together Gary Taylor of Citigroup, Jeff Schaub of Fitch Ratings and Robert Berenson of the Urban Institute to discuss delivery system developments. Topics included the impact of health reform on provider organizations, underlying health spending trends, hospital pricing strategies, competitive dynamics between hospital systems, evolving hospital-physician relationships, health information technology adoption and pharmaceutical market developments.

The panelists assessed how the economic crisis and potential reform were affecting hospital capital spending, physician employment trends and the financial outlook for both for-profit and nonprofit hospital systems. The bond analyst's perspective highlighted how reform uncertainty was affecting hospital credit ratings and borrowing costs, while the equity analysts focused on implications for hospital company valuations.

Conference Format and Context

The conference used a roundtable format in which Ginsburg posed questions that had been shared with panelists in advance, followed by audience Q&A sessions. Analysts were not permitted to discuss the outlook for specific companies. This long-running conference series served as a bridge between Wall Street's analytical perspective on health care companies and Washington's focus on health policy, recognizing that the best equity and bond analysts developed deep understanding of the markets and policy forces affecting the companies they followed.

Sources and Further Reading

This conference was organized by the Center for Studying Health System Change, a nonpartisan policy research organization funded by the Robert Wood Johnson Foundation and affiliated with Mathematica Policy Research.