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CMS Quality Conference

Sylvia Mathews Burwell
December 2, 2014
Baltimore, MD

AS PREPARED FOR DELIVERY

Introduction

Thank you, Dr. Conway. I want to say a special word of thanks to the Hospital Engagement Networks for all of your hard work, along with the Quality Improvement Organizations, providers, and others in the room that have worked tirelessly to improve patient safety.

I had occasion earlier this morning to meet two truly inspiring people whose work encapsulates what I think we’re all trying to accomplish. Their names are Ciaran and Orlaith Staunton.

If you visit Jackson Heights in Queens, New York, you might come across Rory Staunton Field, which is named for their beloved son. At only 12 years young, Rory lost his life to sepsis, which occurs when the chemicals the body releases to fight infection cause inflammation throughout the body.

Rory contracted the infection after falling in the gym at school. Early recognition and treatment could have saved him. Now his parents have made it their life’s work to save the lives of others.

I know that for so many in this room, improving health care safety, improving health care quality, saving lives – this, too, is your life’s work.

This is why I wanted to come and see you all today. As you know, at the Department of Health & Human Services, we work on a number of very important and timely issues. To me, these issues are some of the most important and the most timely.

From my very first days as Secretary, I’ve made it a priority to meet with businesses, hospitals, physicians, health plans, and consumer groups to discuss these issues. In fact, I just recently had the opportunity to meet with the American Academy of Family Physicians as well as the state Medicaid directors.

If you consider the progress we’ve made – and the progress we’re on the verge of making – the evidence suggests we could be at an important moment when it comes to the way we deliver health care in this country. But to get there, we need to make an even bigger push.

So I’m here to ask for your help in picking up the pace of our progress. So many of you have contributed so much to the progress we’re achieving – and in fact, I have some news to share with you in a moment, that shows we have some significant momentum.

We need your help taking this to the next level.

How We Got Here

Now, for all the differences of opinion about how to move forward as a country when it comes to our health care, there is one area for which we have near unanimity – and that is in the sentiment that the health delivery system that’s been in place for the last 50 years has under-delivered on affordability, access, and quality.

As I said to the family physicians when I attended their national conference a few weeks back, you could almost sum up the past half century in a sentence: The prices we paid far outpaced the progress we made.

Health care costs grew significantly faster than things like GDP and middle-class family incomes – and we all felt the effects of a system that did not spend our health care dollars as wisely as it could have.

Moms and dads felt the effects as they sat down at the kitchen table to work out their family budgets. Businesses felt it on their income statements.

Not only did we pay more, in some cases we also got more, too, but sometimes we got more of the wrong things: more unnecessary tests, more preventable read missions, more health care acquired infections.

Surely, we’d all agree that parts of our system simply did not make sense. We waited until patients got sick in order to treat them, rather than focusing on prevention. Our payment models incentivized volume rather than value.

Delivering Results

If we’re being straightforward with one another, there is something else about our system that was broken for generations – and that’s the way we chose to work on fixing it.

It used to be that all too often government was over here, business was over there, nonprofits were someplace else. Today, we’re working together like never before, and we have some historic progress to show for it.

Let me give you an example. For decades, we had some areas of success in improving quality and safety, but struggled to move the needle nationally.

For the past three years, instead of working in siloes, we’ve partnered with hospitals that represent 80 percent of the American population. As a result, we’ve been able to achieve dramatic improvements in patient safety.

You might have heard that between 2010 and 2012, we drove down the harms that patients received in the hospital – things like infections, complications, and adverse events by 560,000 incidents, a reduction of nearly 10 percent.

Today, we’re releasing a new study from AHRQ, the Agency for Healthcare Research & Quality, supporting work done by CMS and all of you. The report shows that we’ve built on our success – and we’ve done so significantly:

According to our preliminary data, between 2010 and 2013, we reduced hospital acquired conditions by 1.3 million events – with much of this progress coming over the last year.

That’s more than a million fewer instances of things like pressure ulcers, central line associated infections, and falls and trauma.

This represents a 17 percent reduction – and this a very significant number. It represents historic progress on health care quality. It represents healthier patients and health care dollars being spent more wisely.

It also represents a savings of approximately $12 billion in health care costs.

And most importantly of all: It represents an estimated 50,000 fewer people who lost their lives. Just think for a moment, about what saving even one life means to a family … a congregation … a community. What it means to have one more full seat around the Thanksgiving table.

Meanwhile, the record will show that nationwide, health care price inflation is at its lowest rate in 50 years.

Medicare spending per beneficiary was essentially flat in nominal dollars this fiscal year, and it’s been growing slower than GDP per capita for the last four.

And – thanks in large part to the work of so many of you – we’ve driven down Medicare hospital read missions by 150,000 people over the past two years.

Think of the difference it makes to a family to have a loved one home for the holidays instead of in the hospital…

Now, at HHS, we have term for this kind of progress: “a start.”

Vision

The question is, how do we build upon this progress? How do we take it to the next level?

I want to share with you my vision for how we get there:

I believe that as Americans, we will receive better care – and spend our dollars more wisely – if we find better ways to deliver care, pay providers, and distribute information.

To drive progress on these goals, we’re focused on supporting you, as you find new ways to coordinate and integrate care.

We’re focused on engaging patients more deeply in decision-making. And like you, we’re also focused on improving the health of our communities – with a priority on prevention and wellness.

When it comes to improving the way providers are paid, I want you to know that we share your commitment to rewarding value and care coordination – rather than volume and care duplication.

Like you, we want to pay providers for what works – whether it’s something as complex as preventing or treating disease or something as straightforward as making sure a patient has time to ask questions.

In addition, as we look to improve the way information is distributed, we’re working to create more transparency on cost and quality information, to bring electronic health information to more places, and to bring the most recent scientific evidence to the point of care so we can bolster clinical decision-making.

We know Medicare and Medicaid are the two of the largest health insurance plans in the world. Together they cover roughly 1 in 3 Americans.

So one of the things we’re doing is identifying the grant and rulemaking opportunities – and finding ways to use them appropriately to improve the quality of care that beneficiaries receive while spending dollars more wisely.

The bottom line is that we understand that it’s our role and responsibility to lead, and we will.

What we won’t do – and can’t do – is go it alone. Patients, physicians, government, business – we all have a stake. And I believe that this shared purpose calls out for deeper partnerships.

Conclusion: Two Asks

So as I wrap things up, let me leave you with two asks.

The first, again, is that I need your help in accelerating the pace of our progress. It’s people like you who drive progress – now, collectively, we need to put our foot on the gas, so we can drive faster.

So today, I’m asking you to join me in a call to action. I need your help in thinking creatively and engaging your colleagues on practices that will improve patient safety.

A 17 percent reduction in hospital-acquired conditions is a big deal, but it’s only a start. No American should ever lose his or her life, or spend the holidays in the hospital because of a condition that could have been prevented.

I also want to ask for your help with Open Enrollment. If we’re ever going to make the progress we need to make on prevention, wellness, and population health, we have to insure more of the uninsured – and continue getting better coverage to the under-insured.

So I hope you’ll talk to your colleagues and speak up in your communities. And I’m asking those of you who see patients to talk with them as well about the importance of renewing coverage and signing up for new coverage.

I thought I’d close the way I opened – and that’s with the story of Rory Staunton. Rory was known for his kind heart and compassionate soul. Although his life was short, it was filled with joy, generosity, and accomplishment. He once flew a plane. He met the President. He set up an award-winning Lego Robotics Team. And he led a campaign at his school to eradicate the use of a derogatory and hurtful slur.

Rory’s story reminds us that every life is precious. Every life has meaning. And that the most important life we save is the next one.

In September of last year, we added sepsis to the Partnership for Patients, meaning that more than 1,500 hospitals nationwide are committed to driving down sepsis-related harms and reporting on their progress, so that we can prevent future deaths.

The poet Hannah Senesh wrote that just as “There are stars whose radiance is visible on Earth though they have long been extinct. There are people whose brilliance continues to light the world even though they are no longer among the living … They light the way for humankind.”

Rory’s light shines on through the lives you have saved. It shines on through those lives we will save in years ahead. It shines on through our work together to eradicate preventable harms.

As we move forward, I hope to continue our work together. Together, let’s take this to the next level. Let’s improve quality. Let’s spend our dollars more wisely. Let’s save lives.

Thank you.

Content created by Speechwriting and Editorial Division 
Content last reviewed on January 6, 2015