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Berwick Calls on Insurers to Work With CMS

 |  By jsimmons@healthleadersmedia.com  
   September 14, 2010

In his first major speech since becoming head of the Centers for Medicare & Medicaid Services (CMS) two months ago, Donald Berwick, MD, on Monday urged insurers—along with employers, professional groups, and communities—to join together in advancing healthcare reform goals.

"All of us have to change the way we do business," he told attendees at the America's Health Insurance Plans (AHIP) conference on Medicare and Medicaid in Washington. "There's plenty of work ahead. I just know I can't do this alone. CMS can't do this alone. Government can't do this alone. We will either build a new healthcare system for our country together...or we're not going to build it at all."

But Berwick also emphasized--in what might considered a continuation of the tug-of-war relationship between CMS and AHIP over healthcare reform issues--that those who wish "only to preserve the status quo" are not going to be "constructive contributors to our nation's future."

Berwick's presentation before AHIP comes just a few days after his boss, Health and Human Services (HHS) Secretary Kathleen Sebelius sent a sternly worded letter to the trade group for some of its members "falsely blaming" the healthcare reform law for rate hikes for the upcoming year.

"It's a stark, clear reality that our healthcare system, in its current form, is not up to that job," Berwick said. "We cannot, with our current system of care, give Americans the care that they need and want and deserve."

As a way to pursue changes, Berwick said, "My door is wide open. It's open to the associations, delivery systems, professions, and other leaders who will join authentically in the pursuit of the 'Triple Aim' for America," he said in reference to an article he co-wrote two years ago in Health Affairs.

In that article, Dr. Berwick proposed a three part strategy to improve the experience of patient care, while addressing the population wide causes of disease and reducing per capita costs of healthcare.

To address population health, Berwick called for expanded prevention and treatment of diseases such as obesity and depression, along with more attention to underlying causes such as violence. Patients should no longer have to resubmit their personal information every time they go to a physician, and providers must better coordinate their care, he said.

On how to lower costs, he suggested "eliminating waste and needless hassles" though did not go into the specifics. Berwick did caution them against maintaining a system under which physicians were paid more if they did more.

As providers "find and adopt their own goals, CMS can help--and we will help--by adjusting payment methods to support that" and by making it "easier and easier for people to find best practices in neighborhoods and across the country," he said.

Karen Ignagni, AHIP's president and CEO, after Berwick's prepared comments said: "We intend to work with you to get it right."

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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