NORWOOD, Mass. -- Representatives of both sides of the political divide presented contrasting viewpoints on how reforming health care impacts IT at the New England Healthcare Information Management Systems Society (HIMSS) 5th Annual Public Policy Forum.
Former Harvard Pilgrim Health Care CEO and current Massachusetts Republican gubernatorial candidate Charlie Baker called for tort reform -- limiting payouts for malpractice suits, as well as public disclosure of physician performance statistics and fee scales to keep health care costs in check. The latter, he said, amounts to pay-for-performance, because consumers will be able to shop around and see which doctors meet their needs on the price-performance grid.
"Information technology can be an incredibly powerful tool to improve performance," Baker said. "If we really want people to engage in [reforming health care] in a serious way, we should get much more aggressive about encouraging the public disclosure around price and performance so that people who need to get better will be compelled to figure out a way to do that."
U.S. Sen. Sheldon Whitehouse (D-R.I.), meanwhile, endorsed current health care IT initiatives and celebrated Congressional support for reforming health care. He added that he has proposed to the Obama administration a new class of meaningful use qualification -- "leadership communities of effort," he calls them for now, in which meaningful use goals are evaluated on the community level as a whole.
"You [wouldn't] have to show, doctor by doctor, provider by provider, that you are participating and have met all the different standards," said Whitehouse, who advocated the Beacon Communities program in the HITECH Act, off of which he spun this idea.
Under Whitehouse's proposal, physicians can still qualify who get most of the way to electronic health record (EHR) meaningful use compliance but fall short of current rules for receiving financial incentives. The idea is to reward leaders who are working toward health information exchange and all the quality indicators in the meaningful use statute, because they will create the templates that the average provider eventually will use.
Talented, capable, truly invested providers and practices could slip at one small element of the meaningful use standards and fall out in a way that, frankly, isn't helpful to the overall effort.
Sen. Sheldon Whitehouse (D-R.I.)
As the regulations are presently written, "Very, very talented, very, very capable, truly invested providers and practices could slip at one small element of the meaningful use standards and fall out in a way that, frankly, isn't helpful to the overall effort," Whitehouse said. He urged audience attendees who liked the idea to register support for it with the Office of the National Coordinator for Health Information Technology. "It just provides another way of defining who qualifies under meaningful use, and it does it through the quality of the community's effort, as opposed to the quality of the individual effort."
Key to reform: Cutting cost of chronic disease treatment
Both speakers agreed on one point, which was repeated by several other speakers at the event: Patients with a chronic disease account for a great majority (80% or more) of the health care services performed in this country; making their care more efficient is the key to stopping the upward spiral of health care costs that threaten to bankrupt the economy.
Whitehouse suggested that the federal government set benchmarks for cutting costs in line with the provisions of the bill reforming health care; if providers don't hit them, fine-tune the effort, he said.
Baker's solution involves cutting costs by increasing payments to primary care physicians. The health care system, he reasoned, is asking more of PCPs while cutting their reimbursements.
Paying PCPs more, Baker said, should reduce overall health care costs because it will enable them to spend more time with patients -- especially those enduring chronic diseases, who currently get shunted off to more expensive specialists because PCPs just don't have the time to analyze their ailments and cannot order tests, specialist visits or hospital admissions more efficiently than they do now.
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