In his remarks recently at a Bipartisan Policy Center event about health information technology, CMS Administrator Dr. Donald Berwick said there is one rare and very important resource the healthcare industry needs during what he described as “a very fraught time—conflictual, polarized, fretful, worried” and with much uncertainty: optimism.
Optimistically approaching accountable care
Both Berwick and the agency he leads will need that resource now more than ever, as they collect the last of public comments (due today) on CMS' highly contentious proposed rule on accountable care organizations, which was released on the last day of March. And Berwick seems poised to do that, as he said with optimism comes confidence.
“It's not confidence that we know the answers—we don't always know the answers,” Berwick said late last week. “It's confidence that we can find the answers. We're smart enough, good enough and wise enough as a country to do that, even when we disagree—we can navigate to the answers,” he added.
The beginning of Berwick's quote may sound like something from Stuart Smalley, the character that now-Sen. Al Franken (D-Minn.) played years ago on “Saturday Night Live." But his message is still an important one, as CMS tries to fix the proposed rule after healthcare CEOs and associations including the AHA, AMA, AMGA and MGMA have submitted their criticisms of it.
In a brief question-and-answer period, Berwick was asked what he thought of a recent letter to HHS from seven Republican senators about the rule. In that letter, they said the ACO proposed rule “misses the target.”
To his credit, Berwick stayed consistent with his earlier theme of optimism when he replied that he welcomed that letter and all others that addressed the proposed rule. Sure, he's a federal official who is supposed to stay on message. But the point is that that the message he gave was one of optimism, rather than defensiveness—which could bode well for providers seeking real change in the final rule.
“We need to be careful pulling it off. We're trying to do that,” Berwick said. “The proposed rule had many, many different things we were trying to adjust and balance—sharing data against patient privacy interests, rewarding savings but under tight, quality scrutiny; encouraging cooperation but not collusion—all of these balances are in that (proposed rule) So it was a try to get it right,” he added. “The input we're going to get now is going to help us get it righter.”
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