“You cannot say it cannot be done,” he said during a keynote address this morning. “We don't have to cash in on this one—we can solve it.”
In his speech, Berwick pointed to six areas where waste occurs: overtreatment, failures to coordinate care, failures in care delivery, excess administrative costs, excessive healthcare prices and fraud and abuse.
He cited a study he conducted that found that 34% of 2011 healthcare spending was wasteful. One in $3 spent on healthcare “helps no one at all,” he said, “all of it potentially available for other uses.” The estimated impact would amount to $11 trillion over nine years.
Berwick pointed to a number of initiatives underway to tackle areas of healthcare inefficiencies around the world, from patient-directed care to training new caregivers in underserved regions.
The American Board of Internal Medicine's "Choosing Wisely" campaign also identifies a list of overused tests and procedures and included more than 35 specialties as of February.
But hospitals aren't always moving in the right direction. Systems are consolidating, he said, and there is backlash from the public. "Prices are going up when they should be going down."
“You know the problem: It's a transition problem,” he said. “It takes courage to deal with this."
Berwick noted that there is a 400% difference in per capita healthcare spending between the highest and lowest areas, with low-cost regions often besting the more expensive ones in outcomes.
“If you're only playing the old game, you'll have the (old) results, and they're not going to be good enough,” he said. “The only way to produce value is to meet the needs in front of you and reduce waste.”
Berwick said it's critical that policymakers and providers figure out how to remove the waste from healthcare in order to afford other demands of government, such as schools and roads. That, he said, played a role in his decision to run for governor in Massachusetts.
"The best way to reduce healthcare costs is to improve the care—that's been my lesson learned for 30 years," Berwick told Modern Healthcare. "The unfinished business in Massachusetts is to complete the process of reforming healthcare so it really meets people's needs."
Berwick's previous stint attempting to address those challenges from inside government was somewhat rocky—the Republican opposition to his appointment as CMS administrator was so fierce that he never got a confirmation hearing.
The vitriol, though, was "background noise" during his tenure at the CMS and has done nothing to disuade him from politics, Berwick said. "Many of the attacks on me were irresponsible. They were frankly lies. They were mischaracterizations of what I believe, and despite my attempts to explain what I believe, they just went ahead and said what they wanted. That was a game."
Follow Beth Kutscher on Twitter: @MHbkutscher
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