Former HHS Secretary and Utah Gov. Mike Leavitt wasn't quite talking about a healthcare apocalypse when he addressed the College of Healthcare Information Management Executives as a keynote speaker Wednesday, but he did invoke Charles Darwin's survival of the fittest and mounting global economic distress that will inexorably push the U.S. to contain its healthcare costs.
Virtually all previous efforts to reform the U.S. healthcare system—either by law or regulation—have been driven by a sense of compassion as “part of the American ethos,” Leavitt said.
And while compassion will remain a part of the calculation, “we are being driven by a Darwinian instinct to bend the cost curve. It's being driven by a sense of global economic dispassion. It will travel with glacial certainty. So, positioning ourselves is of vital importance.”
Leavitt, as HHS secretary, was actively engaged in promoting health information technology. He headed the American Health Information Community, a federal advisory panel that spent a good deal of its time devising use cases around which standards and implementation guidelines were developed for health IT transactions. AHIC operated in the days before passage of the American Recovery and Reinvestment Act of 2009, which authorized spending billions of dollars on a host of IT incentive programs. Leavitt supports federal IT efforts thus far.
“Would I have liked to have had the $18 billion to drive our work to develop standards?” he asked, rhetorically. “I confess to you I really would. I support the fact that we've invested so heavily.”
But Leavitt said he fears “we're going to have our standards lag behind the regulation. My position is that standards need to be the leading part, but I think that generally we're on the right track.”
Leavitt said he sees healthcare coalitions led by physician groups, hospitals and health plans all jockeying for pre-eminence, seeking to become the “general contractor” of healthcare delivery and payment in 350 or so local or regional healthcare markets nationwide. None of the three will ever dominate across all markets, he predicted.
Finding innovative ways to deliver value will be a key determinant of success in the future, Leavitt said.
Every generation has faced just such a significant challenge, he said. “Some it was a world war, some it was the Great Depression, but this is ours and it is a challenging moment in our history. There are really only three ways you can approach it. You can fight it and die. Or you can accept and have a chance to survive. Or you can lead it and prosper.
“This is a moment for enterprises in the health sector to begin to lead,” he said. “The way to prosper in the next decade and beyond is to position yourself as an innovator.”
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