Writing for Health Affairs' blog, HHS Secretary Sylvia M. Burwell outlined her vision for the future of healthcare after the Obama administration leaves the White House.
"This is the path forward — a system where innovative actors are putting the patient at the center — and, despite differences in healthcare, I firmly believe it is a vision on which we can all agree," Sec. Burwell wrote.
In the blog, Sec. Burwell highlighted five key areas of focus needed to continue to drive improvements in the access, quality and cost of healthcare.
1. The system must continue the transformation from fee-for-service medicine to value-based care. These changes have been proven to drive down costs and put emphasis on work that was previously uncompensated, particularly care coordination tasks, according to Sec. Burwell. "Improving access and quality while reducing cost is not just achievable — it’s a national imperative, one we’re working on right now, and one future policymakers would be keen to follow," she wrote.
2. The Center for Medicare and Medicaid Innovation has been critical to healthcare reform. It has helped realign payments to reward providers for value not volume, promoted care coordination and driven improvements in health IT, according to Sec. Burwell. "With this tool, and in concert with the private sector, we have moved beyond incremental, fractured steps toward large-scale, strategic change," she wrote.
3. Alternative payment models are a work in progress. ACOs, bundled payments and other reforms like the Medicare Access and CHIP Reauthorization Act are helping drive change, even in the private sector, but still may need some fine-tuning. MACRA in particular is still being developed. "Implementing MACRA has just begun, and we know questions will continue to arise regarding whether we have sufficiently tailored the program to support small and rural practices, or whether there are enough alternative payment models available. To address these challenges, we plan to continue working closely with clinicians and patients, listening to their concerns and ideas, and responding to their feedback," Sec. Burwell wrote. "This is just the beginning."
4. Providers need better tools to support practice redesign. CMS has started to do this through programs like the Comprehensive Primary Care Plus model, the Medicare Diabetes Prevention Program and the Transforming Clinical Practice Initiative. However, more work is needed to refine these models and spread their adoption. "If you look across the healthcare system today, the same services vary significantly in cost and quality at different providers. To close that gap and improve the delivery of care for every provider, we need to help Medicare transition to policies that better reward coordinated, quality care," Sec. Burwell wrote.
5. Data must be more easily accessible. This means health systems should use interoperable IT systems, patients should own their information and rules and regulations should be in place that allow for simple, secure data transfer, according to Sec. Burwell. "In a better healthcare system, it should be easier for clinicians to track vaccinations or screenings, and easier to give a second opinion. In such a system, patients and providers should be able to see everything that has or hasn't worked for a given condition, so they don't repeatedly start from square one," she wrote.
Read the full blog here.
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