Donald Berwick’ High Points
1 Changes are already occuring.
2.Feels changes will continue even if President Obama is not elected.
3. Medicare is only part of the reform, insurers already making significant changes
4. Change impact differs from state to state
5. Great deal of distrust and with whom to partner
6. He feels like it is a new era…triple aim seems to within reach. Better care, Lower cost, Better outcomes.
7..Great progress in parental infections.
8 Seamless care is improving
9. Transition to new business model is difficult….two separate business models.
10. Some money is still on the table….state’s refusal to implement HBE and others. Many ‘red’ states have refused….and if President Obama is not re-elected may get worse, more states will ask for waiver.
11. Repeal is unlikely….process will be ‘reconciliation’
12. Believes the entire PPACA could be repealed.
13. Political aspects are already in progress 1. Dependents 2.Insurability
14. Government and “ those inside the beltway” are aware of the animosity about pro v . con ACA. Education is extremely important to allay fears of “creeping socialism” (author’s term)
15. Imporant moment for ‘clinical leadership’ and Improvement in health system will far outweigh the public system changes
16. Berwick invites all to attend IHI Conference in D.C. November 8-12 at Knight Conference Ctr
Questions at the end of the talk were addressed.
Chat room:
Only one more minute on our last poll.
from Sean Berry to All Participants:
from Sean Berry to Host & Presenter:
from Anne Sampson to All Attendees:
In your opinions, which Presidential candidate represents the best chance for continued healthcare reform?
from Thomas Moses to All Attendees:
Is there any way to de-politicize PPACA?
from John Sutton to All Participants:
Please discuss any differences in graduate medical education funding between the two candidates if possible.
from Richard Sheff to All Attendees:
What are the likely options for "repeal and replace" if Romney is elected?
from Gary Levin to All Attendees:
Is there the option of not total repeal but amendments?
from Jeff Huebner to All Attendees:
To what extent are the exchanges a lever to improve quality of care at the state level?
from Irene Agostini to All Participants:
What is the best research/data on how to create a more seamless inpt/outpt case management process for patinets for all of the obvious reasons?
from Nancy Lowe to All Participants:
What is going to happen in the States that do not participate in Medicaid reform?
from Sheldon Weisgrau to All Attendees:
It seems that "inside-the-beltway" Washington views much of this as a policy dispute. On the ground in Kansas, its much more controversial - viewed as no less than a "socialist takeover." Is there a recongnition in DC of the level of animosity? A plan to educate people?
from WIHI admin to All Participants:
Lot of great questions - make sure they're directed at "ALL PARTICIPANTS" so everyone can see them.
from Sheldon Weisgrau to All Participants:
It seems that "inside-the-beltway" Washington views much of this as a policy dispute. On the ground in Kansas, its much more controversial - viewed as no less than a "socialist takeover." Is there a recongnition in DC of the level of animosity? A plan to educate people?
from Skip Grieser to All Participants:
Efforts to create multidisciplinary clinical teams are hindered by structural issues -- the time it takes for teams to meet while not getting paid for it, reimbursements and co-pays to each provider, etc. What are your ideas for solutions?
from Nels Johnson to All Attendees:
What importance does tort reform play in health care cost reduction in the U.S.?
from Janis Licari to All Participants:
Health care organizations are required to meet a wide variety of guidelines, regualtions, standards that consume a huge amount of administrative resources and contribute to the cost of care. Do you see any future movement to consolidate these somehow?
from v sean mitchell to All Participants:
Many of us have signed on to a law suit to prevent the repeal of the AFCA, if Romney wins. The law suit is scheduled to be filed both in the federal courts and state courts, the moment a repeal of the AFCA is issued. Do you believe the Supreme Court would rehear the case?
from Ellen Heuduska to All Participants:
How do mediicaid covered citizens fit into the ACO model?
from Diana Conco to All Attendees:
If Obama is re-elected and ACA is fully enacted will there still be uninsured needing free clinic services?
from Abby Nagel to All Participants:
If the ACA is allowed to be rolled out, will there be efforts to share the logistics of those health exchanges that are effective and reduce costs.
from Gary Levin to All Attendees:
Is there a way to save or listen to the proceeding later?
from Jeff Huebner to All Attendees:
two physician groups National Physicians Alliance and Doctors for America have been actively working on education efforts about ACA and health reform more broadly
from Judi Withers to All Attendees:
Couldn't we get futher, more quickly, in expanding health coverage for all by reinvesting in the existing US Public Health System?
from Gary Levin to All Attendees:
Judi Withers: that would be a great approach. PHS is now an oxymoron....very positive approach
from Gary Levin to All Attendees:
Has HIT,EHR and HIE made any measurable improvement in the system yet?
from Tiffany Francis to All Attendees:
For 8 states partcipating inthe CMS Primary Care Transformation Project utilizing PCMH offices, do you anticipate after the three years it will stand as the "standard" for CMS structure?
from WIHI admin to All Participants:
from gale marsh to Host (privately):
from gale marsh to All Attendees:
what provisions have been made for tort reform to accompany these changes?
from Cindy Robertson to All Attendees:
What is your advice for rural health providers for whom it is impossible for them to be an integrated system or ACO on their own, and for whom larger urban systems have very little interest in working with due to our very high government payor mix?
from Nels Johnson to All Participants:
Any best practice advice in managing the transition between fee for service and pay for performance?
from Tiffany Francis to All Attendees:
For 8 states partcipating inthe CMS Primary Care Transformation Project utilizing PCMH offices, do you anticipate after the three years it will stand as the "standard" for CMS structure?
from WIHI admin to All Participants:
from gale marsh to Host (privately):
from gale marsh to All Attendees:
what provisions have been made for tort reform to accompany these changes?
from Cindy Robertson to All Attendees:
What is your advice for rural health providers for whom it is impossible for them to be an integrated system or ACO on their own, and for whom larger urban systems have very little interest in working with due to our very high government payor mix?
from Nels Johnson to All Participants:
Any best practice advice in managing the transition between fee for service and pay for performance?
from Madge Kaplan and Don Berwick to All Participants:
Thrtr
from Madge Kaplan and Don Berwick to All Participants:
There's a terrific article Don co-authored in JAMA on this issue that we'll include in our resource document
