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Getting More Out of Every Dollar: Improving Health Delivery in America

Improving America's health care delivery system is one of my top priorities here at the Department, and it has been since Day 1.

We all have a stake in improving the quality of health care we receive, while spending our dollars more wisely – and it’s important to business, taxpayers, and patients alike that we get it right. That’s why improving our health care delivery system is one of my top priorities here at the Department, and it has been since Day 1.

Since President Obama took office, we’ve worked to hold down health care cost and now sustained spending growth is at a 50 year low – and we’re all benefitting.  What’s more:

  • We’ve saved taxpayers $116 billion from 2009 to 2012 compared to what costs would have been if they’d followed the same trajectory as the 2000 to 2008 period –with the help of improvements we made to Medicare health delivery as well as other changes.
  • Last year, we drove down Medicare hospital readmissions almost 10%.
  • Between 2010 and 2012 as a country, we drove down patient harms 10%– saving 15,000 lives and driving down costs by $4 billion. 

Still, there’s more work to do.  As the Bipartisan Policy Center CEO Council reported today, we spend more as a country on health care per capita than any nation on earth.  And businesses pay out $576 billion each year because the population is less healthy than it could be.

At HHS, we understand that it’s our role and responsibility to lead in the areas we can.  Medicare and Medicaid are the two biggest health insurance plans in the world.  In total, they cover roughly one in three Americans.  And we believe there’s a lot of opportunity there to deliver better care to beneficiaries, while spending taxpayer’s dollars more wisely.

We’ve identified the opportunities that we have through current programs, grants, and policies and we’re focused on leveraging them appropriately to drive impact.  Take for example Accountable Care Organizations where doctors and hospitals work together to coordinate the care they provide to patients.  Patients get better care because their doctors work together more closely, keeping track of medical problems, coordinating referrals, and improving health and reducing wasted time and hassle for patients.  Taxpayers get savings because their dollars are invested more wisely.  As we test these models, 5 million people are benefitting. And taxpayers are saving $370 million and counting.

Today, I want to outline our plan to drive progress on this issue and give you preview of what’s to come. To guide our work in this space, today we are advancing three key areas of focus for improving care while investing dollars more wisely: incentives, tools, and information.

Let’s start with the first, incentives: changing the way we pay for health care in this country.  We want to work together to build a better health care system that is less volume-based and more outcome-based.  We want to pay providers for what works – whether it’s something as complex as preventing disease or something as simple as making sure a patient has time to ask questions. We want to step away from the incentives that encourage medical offices to squeeze in as many patients as possible, or to conduct as many procedures or tests as they can, even if they are not always necessary.

This includes expanding the adoption of new alternative payment models in Medicare and Medicaid.  It also includes fostering demonstration projects to identify improvements to Medicare payments.  It means working with the private sector to expand accountable care and other models that have been proven to work.

Secondly, the tools. To further drive progress, we’re committed to empowering doctors, hospitals, and patients alike with the tools that give them the “capacity to change” and deliver better care – by providing technical assistance  and grants in areas such as practice design and transformation, electronic health information, and recruiting and training a world-class health care workforce.

Some of the most impactful actions we can take involve working in partnership with state governments.  States are doing important work on innovations like Patient Centered Medical Homes, Accountable Care Organizations, and strategies for improving care for so called “dual-eligible” – folks who are eligible for both Medicare and Medicaid.

Finally, information. We all want to equip patients with information to make good use of time with their doctor so that they can actively participate in their own care. By empowering doctors with information, they will make the most of the time they spend with their patients.  And, when all of a patient’s doctors talk to each other, patients get more personal attention and better care.  That’s why the ability of health information technology systems to talk to each other – interoperability – is also a significant part of this.

We’ve set out to improve the flow of information for patients and their doctors by releasing privacy-protected Medicare data, posting quality performance data for providers, and making our health information systems more interoperable. 

There’s more to come. I’ve told our team at HHS that we’re not here to fight last year’s battles.  We’re here to work for affordability, access, and quality.  Improving the health care delivery system is key to delivering results on all three of these priorities.

So what you’ll be seeing from us in the days, weeks, and months ahead is an open invitation for partnership -- and a call for good ideas – no matter where they come from – particularly when it comes to improving our nation’s health delivery system so that we spend dollars more wisely and receive better care. 

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Health Care
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