‘In the hands of providers’
Docs: Cost reduction required to prevent cuts
Leading government and private-sector physicians are asserting that the onus is on healthcare providers to reduce the continued surge in costs that will otherwise require huge cuts in publicly funded healthcare programs.
Controlling the rise of healthcare costs was central to both a recent House-passed budget plan and President Barack Obama’s newly introduced deficit-reduction “framework.”
“If the delivery system innovations are not as successful as we need them to be, it would seem to me at least, that there would be no choice but for payers—businesses and governments and others—to step in with more gross and firm measures to make sure cost increases do not continue to escalate at an unsustainable rate,” said Dr. Edward Murphy, president and CEO of Carilion Clinic in Roanoke, Va. “That would be less desirable than leaving it in the hands of providers to innovate and figure out ways to do it themselves.”
Dr. Gary Gottlieb, president and CEO of Boston-based Partners HealthCare System, said the increasing focus on federal deficits by politicians from both major parties has made it clear that there will be healthcare impacts.
“From my perspective, in terms of what I do, I better be sensitive to the notion that there are going to be less resources that are going to be available to us in the long run,” Gottlieb said in an interview. “We’re going to have to think about how to use the resources that have been so precious to us for a long period of time in ways that are more effective to deliver the care that we need to deliver.
Many providers have raised concerns about the impact of Obama’s deficit proposal, which includes more authority for the Independent Payment Advisory Board to make cuts to Medicare after 2018 and use of a debt trigger to implement cuts to programs if medical costs rise faster than a predetermined rate.
Dr. Donald Berwick, administrator of the CMS, described Obama’s proposal in an interview as “an important idea.” However, he said, if CMS initiatives with providers to improve care and reduce costs are successful, “that trigger will never need to be pulled.”
Biomedical research could help providers improve care and reduce costs in the long run, Dr. Francis Collins, director of the National Institutes of Health, said in an interview.
“We are limited by resources at a time where inflation has been eroding our buying power for medical research so that we have actually slipped back to where we were about 10 years ago,” he said.