‘In the hands of providers’

Docs: Cost re­duc­tion re­quired to pre­vent cuts

Modern Healthcare - - The Week In Healthcare - Rich Daly

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.

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