HHS Secretary Alex Azar spoke to the American Health Care Association and National Center for Assisted Living in Washington, D.C., June 5 about the transition to value-based care in the post-acute environment.
Here are six highlights from the transcript of his speech.
1. On the needs of the aging population: "American healthcare is changing rapidly, and America itself is changing, too. The number of Americans in need of services to maintain their health and independence as they age is rising, and the number of disabled Americans in need of such services is growing as well."
2. On why now is the time to change how older Americans are cared for: "One reason is that the finances simply will not work. We need higher quality, lower-cost settings for caring for older Americans with serious health conditions. But another factor is that our aging generations will have different expectations, needs and capabilities … Many of them want to age in place, maybe nearer to family … [And, they also have] more exposure to consumer-driven elements of our healthcare system, like choosing from a wide array of insurance options from their employer. They have much more experience interacting with healthcare technology ... but think about the next generation of older Americans: They’ll have mastered technology much earlier in their lives."
3. On the need to drive value-based care: "This spring, I laid out four areas of emphasis for building a system that delivers value: maximizing the promise of health IT, improving transparency in price and quality, pioneering bold new models in Medicare and Medicaid, and removing government burdens that impede care coordination. The common thread for these priorities is the recognition that value is not accurately determined by arbitrary authorities or central planners. The best way to identify and reward value is a marketplace of many players — providers, patients and, where necessary, third-party payers."
4. On bringing technology to the post-acute setting: "Earlier this year, as some of you may know, I spent some time in the hospital — the first hospital stay of my adult life, in fact. … The experience was, first of all, a reminder of how fortunate we are to have access to such high-quality healthcare in our country. But it did bring home for me how challenging it is to be a patient — and just how much information and data are required to deliver the right treatment. Even though I stayed within one hospital system for inpatient, outpatient, specialist, primary care, and diagnostics, the lack of interoperability between multiple EHR platforms meant that I had to relay my medical history, my medications list, and the like to each new doctor or nurse who attended to me."
5. On potentially new changes to the post-acute setting: "We at HHS don't want to micromanage how interoperability is reached, but we are going to provide the right incentives to make it happen. We have issued an RFI, attached to our new SNF payment rules, regarding interoperability incentives and the administration's broader efforts to put patients in charge of their own data … we have proposed making public four key pieces of data regarding SNF quality, building on the important strides that have been made under the [Improving Medicare Post-Acute Care Transformation] Act's quality reporting and standardization requirements. One key element of quality assessment for post-acute care facilities is cutting down on readmissions … The final two areas of emphasis for value-based transformation ... are pioneering new models and payment systems in Medicare and Medicaid and removing government burdens."
6. On the goals for a value-based system: "A system that pays for value will aim to move patients into the lowest-cost appropriate setting. We are interested in ways that Medicare and Medicaid can better support the kind of coordination and integration needed for these transitions. This will likely involve stronger connections between the healthcare and human services sides of HHS. There may be potential for making more use of community aging and disability networks, which are supported by HHS' Administration for Community Living."
Click here to read the full transcript.
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