In an interview in the Journal of the American Medical Association, CMS Administrator Don Berwick, MD, comments support for healthcare reform, the key ingredients for healthcare integration and the need for new payment systems.
Here are some of the quotes from Dr. Berwick:
A lot of 'excitement' about reform law. "We are implementing a lot of changes through the Affordable Care Act, and I think people are appreciating it. There is a lot of excitement about the expansion of Medicaid and the concept of covering 32 million more people and the investments in innovation and the forms of care."
A variety of models for integration. There is "no cookie-cutter solution" for integrating care. "I firmly believe that the care systems that are capable of helping patients through this journey are going to be highly local and highly adaptive. What integrated care is going to look like in downtown Chicago's [care system] is not going to be the same as a delivery system in rural Kansas. Integrated care should be textured, locally adapted and under local control.
New payment methods needed. "If we want to be able to support integration of care, we have to be smarter about the way we pay. When we pay in fragments, we buy fragments. We have to pay more for outcomes, more for journeys, more for bundles of care instead of individual elements."
Measurement is key. "If we get smarter about measuring, and we are able to understand what is happening with patients through time and space, we can be a supplier of information that both patients and families can use when they make their decisions and clinicians and hospitals can use as they craft their care."
Everyone needs to align. "The challenge, the opportunity, is alignment." There needs to be "alignment with the private sector so it is not CMS off on its own doing things. It gets all of us together, the private and public sector, deciding what we want to accomplish together on behalf of patients and families and healthcare workers."
Rationing won't be necessary. "It is possible in this country—it is within reach—to have everybody get the care they want and need, exactly how they want and need, and at a cost we can afford. There are doctors and nurses and hospitals and clinics that are redesigning what they are doing in ways that are highly productive, where everyone is better off, and rationing is the last thing they are thinking about. And rationing should be the last thing they should be thinking about; they should be thinking about meeting needs."
Read the JAMA report on healthcare reform.
Read more coverage of Dr. Don Berwick:
- Don Berwick Comments on Goals for ACOs and Role of Federal Oversight
- Don Berwick Renounces Rationing, Too Much Bureaucracy
- Don Berwick Plans to Hand Out Billions for CMS Reform Experiments
Here are some of the quotes from Dr. Berwick:
A lot of 'excitement' about reform law. "We are implementing a lot of changes through the Affordable Care Act, and I think people are appreciating it. There is a lot of excitement about the expansion of Medicaid and the concept of covering 32 million more people and the investments in innovation and the forms of care."
A variety of models for integration. There is "no cookie-cutter solution" for integrating care. "I firmly believe that the care systems that are capable of helping patients through this journey are going to be highly local and highly adaptive. What integrated care is going to look like in downtown Chicago's [care system] is not going to be the same as a delivery system in rural Kansas. Integrated care should be textured, locally adapted and under local control.
New payment methods needed. "If we want to be able to support integration of care, we have to be smarter about the way we pay. When we pay in fragments, we buy fragments. We have to pay more for outcomes, more for journeys, more for bundles of care instead of individual elements."
Measurement is key. "If we get smarter about measuring, and we are able to understand what is happening with patients through time and space, we can be a supplier of information that both patients and families can use when they make their decisions and clinicians and hospitals can use as they craft their care."
Everyone needs to align. "The challenge, the opportunity, is alignment." There needs to be "alignment with the private sector so it is not CMS off on its own doing things. It gets all of us together, the private and public sector, deciding what we want to accomplish together on behalf of patients and families and healthcare workers."
Rationing won't be necessary. "It is possible in this country—it is within reach—to have everybody get the care they want and need, exactly how they want and need, and at a cost we can afford. There are doctors and nurses and hospitals and clinics that are redesigning what they are doing in ways that are highly productive, where everyone is better off, and rationing is the last thing they are thinking about. And rationing should be the last thing they should be thinking about; they should be thinking about meeting needs."
Read the JAMA report on healthcare reform.
Read more coverage of Dr. Don Berwick:
- Don Berwick Comments on Goals for ACOs and Role of Federal Oversight
- Don Berwick Renounces Rationing, Too Much Bureaucracy
- Don Berwick Plans to Hand Out Billions for CMS Reform Experiments