In Charlotte on Friday, CEOs from some of North Carolina's biggest players in health care gave their take on why costs are rising and what's being done about it. They spoke at the Charlotte Chamber's health care summit.
BlueCross BlueShield CEO Brad Wilson says the cost of health care is already leading people to delay procedures, cut pills in half or avoid filling prescriptions.
The head of North Carolina's dominant insurance company said part of the problem is the system still revolves around quantity rather than quality.
"In fact, some experts would submit, and I agree, that our traditional method of how we pay - how we're paying by procedure, a la carte - is the single biggest driver of medical cost," Wilson said.
The federal government is working on that. Obamacare set up penalties and bonuses for hospitals based on quality metrics. And last year, Congress passed bipartisan legislation to accelerate Medicare's transition to new payment models for doctors.
Carolinas HealthCare System's new CEO, Gene Woods, says the verdict is still out.
"I think the attempt is right though, trying to align how hospitals have been getting paid for a while, which is pay for performance, with how physicians get paid, which is pay for performance, so we're making that journey," Woods said. "I think that will get better over the next five, six years."
Those at the health care summit agreed another part of the problem is the skyrocketing price of drugs. The cost of specialty drugs in particular rose 34 percent last year for BlueCross, according to Wilson.
Novant Health CEO Carl Armato says as that happens, the industry needs to revisit what qualifies as a "breakthrough" drug.
"Not all pharmaceuticals, prescriptions are going to work for every patient," he said, "so is it really a breakthrough, and does it deserve a breakthrough price?"
Armato says hospital systems like his and Carolinas HealthCare also bear some responsibility for rising prices. The CEOs said consumers can make a difference too by finding the most efficient ways to access care - when they have a choice.