Donald Berwick, MD, Administrator for the Centers for Medicare & Medicaid Services (CMS), urged health plans Monday to join with the government and other stakeholders in helping to overhaul the American healthcare system.
In a keynote given at America's Health Insurance Plans (AHIP) Medicare Conference in Washington, DC, Berwick said the problems with American healthcare are not the failure of doctors and health plans, he said. "The problem lies with the system."
The status quo of fragmented information and care is no longer acceptable, he said.
"I want to make our healthcare system as good as we expect it to be, and I need your help," he told health plan executives. "You have and will continue to have a profound influence."
Berwick said the vision for improving American healthcare "is embedded in the Affordable Care Act," which "by any stretch is landmark legislation."
However, the ACA is only a starting place, he said.
Berwick promised to guide CMS in targeting what he called the "triple aims" – better care, better population health and reduction of per capita healthcare costs. "Hear me very clearly," he said. "Lowering healthcare costs will not come about by harming a hair on any patient's head."
CMS will start focusing first on improving acute care, community care and community-based disease prevention, Berwick said. America is "seriously underinvested" in preventing the epidemic of chronic disease it now faces.
The glue for working together to reform America's healthcare system will be shared goals, not just a shared philosophy, he said. Berwick said setting detailed goals and measuring progress toward them are imperative.
"On my watch, I'm going to make it more feasible for stakeholders to find and achieve their own goals," he said. "And frankly, we don't have much time."
"When we need to, we can and we will play tough," Berwick said. "And we can do that with you, if you want."
"We will make far more progress if we agree and work together and not at cross purposes," he said. "We will either build it together, or not at all."
He also warned that authenticity is a prerequisite. "We don't have time for games," he said.
Berwick said the successful redesign of healthcare would happen community by community, not from the top down. And he invited health plan executives to talk to him. "My door is wide open," he said.
