HLM: So how have you been spending your time in the last year?
DB: For the 30 years prior to CMS, I had been deeply engaged with the improvement movement in the US and abroad, trying to help healthcare get better.
All that got interrupted by my stint in Washington, because there are ethics and procedural guidelines one has to follow, and that disrupted some of those long-standing professional and personal relationships.
So I've been working and visiting with hospitals, healthcare systems and physician groups who are trying to think about the new climate they're in, and how much better care can be with redesign.
And abroad, in Singapore, England and New Zealand, studying what they are doing and learning. Singapore, for example, is very concerned about its aging society, and continuity of care. Their population is growing very fast because they have long lifespans.
And I've been really interested in visits with communities around the U.S. where I see interesting changes starting to take place, where organizations are thinking hard about how to adopt strategies focused on patient centered and community based care.
HLM: What questions should I have asked you that I didn't?
DB: You didn't ask me the optimist or pessimist question. The answer is, I'm an optimist. I like what I'm seeing at the local community level. And the next couple of years, the story of healthcare in America may be told community by community rather than from inside the Washington beltway.