The new CEO of Centers for Medicare & Medicaid, Dr. Donald M. Berwick, has made his very first public policy remarks concerning the services provided by Medicare and Medicaid in America. The comments, made in a September 13 speech in Washington, D.C., highlight the ever-increasing desire for a shift from complicated and expensive funding models to a simpler, bureaucratic-free process.
Since being appointed by President Obama in July of this year the new CEO has attracted both complementary and critical evaluations of his work. This work, in essence, is the largest reshaping of the health care and medication industry ever seen – and is designed to work in tandem with the health care reforms promoted and passed by the Obama Administration earlier in the year.
Medicare Insurance Reform’s “Triple Aim” Plan
Dr. Berwick announced the changes under what he refers to as the “Triple Aim” plan. The three central points of this plan are:
- A higher focus on safety, timeliness, efficiency, fairness, patient-centered action and effectiveness.
- A promotion of the “back to basics” ideals of health care. More focus on underlying reasons for poor health, such as malnutrition, lack of physical activity, substance abuse, etc.
- An overall aim to reduce health care costs per capita.
Whilst the first two points in the Triple Aim plan have been well received, a number of medical professionals have expressed concern about the goal to reduce per capita spending on health care.
Their argument is that a cap on government spending per person would actually lead to an increase in costs and push the US health care sector further towards the same model which is currently employed in Britain (i.e. a single-payer health system).
Medicare Cost Reduction without Service Interruption
Despite the criticism, Dr. Berwick believes that it is possible to reduce per capita health spending whilst maintaining service levels in all health sectors. In fact, his ultimate aim is to reduce costs whilst increasing service quality.
“Too many of us know what fragmented, disorganized care looks like”, he said. On the topic of quality improvement, he noted that care in hospitals and clinical settings needs to be “much better, everywhere and for everyone.”
“The problems do not lie in any failure of good will, benign intentions, or skills of our doctors, nurses, health care managers, or staff. The problems instead lie in the design of the care systems In which they work – systems never built for the levels of reliability, safety, patient centeredness, efficiency or equity that we owe to ourselves and our neighbours”, Dr. Berwick commented.
Responses from Major Health Care Organizations
Two major medical organisations – the American Medical Association and the American College of Cardiology have praised the comments, and have themselves met with Berwick to discuss the issues at hand.
Following a meeting between the AMA Board of Trustees and Dr. Berwick, the AMA commented on the positive nature of Berwick’s approach: “We were pleased to have the opportunity to have this discussion with Dr. Berwick, who committed to working with us to identify key priorities as we move forward”.
From here, we will keep watch on how the new CEO’s objectives are achieved, and evaluate whether or not he can genuinely make a positive impact on an industry which has been so resistant to change in the past.
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