Healthcare Reform an Insider's Game Now

I was still wondering about the SOTU address while I watched a couple of hours of the summit on my computer. As I listened to talk about performance payments, hospital readmissions, bending the cost-curve, and kicking up our innovation mojo, it occurred to me that the president might have been right to soft-pedal any mention of healthcare reform. It's more of an insider's game now. And I don't mean that in a negative way.

Healthcare reform has moved well past the point where mere mention of the reduction of the donut hole or elimination of pre-existing clauses in insurance policies can elicit a round of applause. For now, to the average Joe, healthcare reform is like sausage making. He doesn't want to know the details of what goes into it; he's just hungry for the results.

Take for example the infamous triple aim: better care, better health, lower cost. It's a clever six-word summary of healthcare reform, but actually getting there involves a journey into a complex world of quality measures, shared savings, bundled payments, etc.

Case in point: On the morning of the summit, CMS released an eight-page report, "One Year of Innovation," which details how the agency will spend more than $1 billion on initiatives it hopes will achieve the triple aim.