Health Care Landscape On the Mend, Berwick Says

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Improvements to the health care landscape are beginning to crop up despite pressure on the Centers For Medicare and Medicaid Services (CMS) to slash funding for Medicare and other health care programs in response to poor economic conditions.

So says CMS Administrator Donald Berwick, MD. Speaking at a briefing last week, Berwick said CMS believes that improving health care will decrease costs and make it more sustainable, likening the strategy to that followed by almost every other industrial sector. For example, he says, prices on desktop and laptop computers have decreased as manufacturers have enhanced their functionality.

"It is within our grasp,” Berwick states. “You can see piece by piece, case by case, examples of that playing out.”

Berwick notes that the methods that will improve health care and reduce costs are far more difficult to explain to consumers and providers than is explaining the rationale for reducing health care funding in a politically polarized environment. He now perceives needed changes as “wedges”, or groups of opportunities, for improvements in health care that will decrease costs over time in a step-by-step manner.

Such improvements encompass controlling the “overtreatment” of patients, better coordination of care, the closing of gaps in care through the adoption of best practices, more responsive pricing, and the eradication of administrative procedures that add unnecessary burden to care and fraud and abuse.