Tuesday, November 27th, 2012
Recently IHI convened a group of approximately 150 healthcare delivery and policy experts for Out of the Blocks: Where Does Health Care Go from Here? In a new post on the Health Affairs Blog, panelist Susan DeVore, president and CEO of Premier and moderator Don Berwick, IHI's former president and CEO, discuss how providers and policy makers can work together to rein in costs and move to a more efficient delivery system. Here is an excerpt from that article:
“What requests would you have of the policymakers?” asked Berwick, who is now a senior fellow at the Center for American Progress. “What [other than revenue relief] would help you the most?” DeVore’s reply – “Oh my gosh, I have many requests” – generated laughter. “The regulatory environment: the certificate of participation requirements; the [health information technology] meaningful use definitions; the three-day hospital stay required before you can be paid by Medicare for skilled nursing — things that are just crazy and regulatory that get in the way of people being able to make changes.”
“You would make a deal on that? You would say, ‘We’ll deliver the costs reduction if you give us this relief?’ Is it that simple?” Berwick asked. DeVore’s response: “I think if we could get standards, fewer measures, regulatory relief, FTC [Federal Trade Commission] relief — all these things you need to get out of the way in order to actually effectively reduce the cost — I think people would talk about that.
“I think what they would want is a shared-savings way of transitioning,” DeVore continued. “If there is a way that we have a cost target, we have regulatory relief, we have a way of sharing it that as we learn, as we change – I think they would do that.” She said she would ask for a “national voluntary bundled-payment program with shared savings, like what is embedded in [accountable care organizations], as opposed to in the [Center for Medicare and Medicaid Innovation]. Most of our health systems believe that bundled payment and delivery is the big next step in terms of how you change the way care is delivered and how it is paid for. If we could have a national voluntary program that was scalable” and we “shared the savings along the way, we’d move the whole thing down the line a lot faster.”