What the government can do: Government must take heed of what many providers and commercial payers are doing, including engaging consumers more in their healthcare and rewarding performance and quality rather than volume of services provided.
We have seen positive steps on the commercial side. It is encouraging that the federal government is exploring how to reform the sustainable growth rate for Medicare reimbursement. This is a positive step but clearly just the beginning if we are to address the sustainability of Medicare. We need to modernize Medicare and drive the payment system to recognize better outcomes at lower cost. Medicare so far is taking only modest steps; we need to accelerate the speed of change.
Currently, providers are paid for activity, the work we do, rather than the results we achieve, especially when it comes to intermediate and complex care. Government can modernize the payment system to drive providers to produce better outcomes—safer care, fewer complications and fewer readmissions—at lower cost. That's the first step.
The second step is to allow us to innovate and find better ways of caring for patients. Technology makes it increasingly possible to provide care and share our knowledge at a distance, including across state borders, to provide better care to patients in their hometowns—even in their homes. Government can address complex state-by-state medical licensure rules and reimbursement issues that serve as barriers to that.
The third step: Congress and the White House must fully fund the National Institutes of Health, restoring it to its previous funding levels. Cuts threaten scientific and medical excellence and America's position as a world leader in science, technology, engineering and math. NIH funding is seen as a cost, when really it's an investment, advancing science and creating innovation—and jobs.
What the medical profession can do: As a profession and as individual physicians, we must drive a coordinated healthcare system in which everyone who cares for a patient works together as a team with the patient at the center. That gets us to the right answer quickly. It reduces human suffering, reduces costs and gets patients on the right treatment quickly so they have the best chance of recovering and getting back to work.
And we can work together, pooling our data, to understand what doctors do that provides better outcomes, and what it costs. Providers can collaborate with patients and payers to explore new ways to deliver and finance healthcare, making it more efficient, effective and affordable.
Quality in this country is scattered. We need to understand what works and how we can share that information in a transparent way, so that everyone's quality improves, and so people, no matter where they live, have access to high-quality care.