Berwick urges emphasis on quality

To help achieve what he called “systemic change” in healthcare, CMS Administrator Dr. Donald Berwick said hospital trustees and C-suite leaders should make quality a strategy and consider it when they think about their budgets.

“We built in fragments, so we pay in fragments,” Berwick told attendees Wednesday at the National Journal's health policy summit on the effect of healthcare-associated infections on costs and quality. “So we're not really paying for what we want: outcomes.”

In his interview with moderator Marilyn Werber Serafini of the Kaiser Family Foundation, Berwick discussed how America built its healthcare system in fragmented pieces—focusing on hospitals, physicians, nurses and other disciplines—and how that system no longer works as healthcare has evolved. The solution, he said, is quality.

Citing a recent success in the quality arena, Berwick mentioned the Center for Disease Control and Prevention's report that said rates of central line infections among intensive-care unit patients fell 58% to 18,000 in 2009 from 43,000 in 2001, which the CDC said has saved some 27,000 lives and about $1.8 billion in excess healthcare costs.

Berwick also described steps CMS has taken, and will take, to improve quality, such as rolling out the Center for Medicare and Medicaid Innovation; making improvements to the agency's Hospital Compare website; and changing payments to reward quality and penalize high re-admissions and HAIs.