With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians." From MedPage Today.
With just over 8 months on the job left to go, the head of the Centers for Medicare and Medicaid Services said Tuesday he now has "an obsession with the plight of independent physicians."
Since January, acting administrator Andy Slavitt and other members of agency have been traveling around the country listening to thousands of doctors complain about their electronic health record (EHR) systems, poor payment for their time, burnout, and confusion over quality metric requirements.
And all of this without measureable improvements in care for their patients.
It's all put the healthcare workforce on a precarious edge, he said in so many words.
Especially the primary care workforce. And that's a major problem, he told those assembled at the seventh annual Health Datapalooza conference here.
Because "knowing as we all do that if we don't invest in primary care, we'll invest double or triple when people get unnecessarily sick.
"Through these conversations, one thing became very clear," he said. "What we call 'interoperability' at this point would not be considered an impressive achievement by the average physician," he said.
But Slavitt told those gathered to look at Healthcare.gov for hope.
He said that when it launched 2 and a half years ago, it failed millions of people trying to get health coverage as promised, and was equally discouraging. "Once again, technology was the problem -- until it wasn't."
Fast forward a few months: 20 million people had insurance through the online portal. "What you didn't hear," Slavitt said, "was that after we got the technology functioning, we were using technology to do things that had been never been done before."
Easy comparison of plans brought down prices and brought more service offerings. He said more than two-thirds of those signing up "saved an average of $500 a month," with many other benefits such as waived deductibles in some plans.
Yet, he acknowledged, "while technology now supports us in getting coverage, it is largely failing us in the care experience," he said.
Today, interoperability of EHRs is seen as a similar failure as Healthcare.gov was 30 months ago.
"Robots can perform your mom's surgery but reminding her to fill a prescription? No. Can't do that," he said.
Tell her doctor how her surgery went? "No. Seems too hard," he said, even though "we know that all those things that happen after surgery can be just as important as what happened during her surgery."
But it can and it will, Slavitt promised, in time.
"I have the same feeling we faced" in October 2013, he said.
"We have to rise above proprietary interests and make this a national priority. Having seen it happen, I know we can get it right."
Slavitt's talk was followed by an animated panel discussion moderated by Patrick Conway, MD, CMS's chief medical officer, with American Medical Association CEO James Madara, MD; Geisinger Health System president and CEO David Feinberg, MD; and Chet Burrell, president and CEO for CareFirst BlueCross BlueShield.
At one point during their 30-minute discussion, Feinberg brought down the house with applause. Asked by Conway to identify the biggest barrier to better care delivery, Feinstein pulled no punches to criticize the healthcare industry.
"I think the biggest barrier is that we're completely worried about our own turf," Feinberg said, calling it "a crisis in America, the type of healthcare we deliver, who gets it, the quality, who doesn't get it and the cost.
"Physicians are worried about what's happening to them, you know. The systems are worried about what's happening to them, the insurance guys ... the pharma people, and it's never really been the year of the patient, right?
"And if we're going to fix this, it's going to take a huge dose of selflessness, and I don't see this industry talking about that."
Conway nodded in agreement, noting his own difficult experience "navigating the health system with my own family, friends and colleagues."
To which Feinberg quickly added: "Yes, and think about someone who is health illiterate, (or) the single mom. You're an insider, you're as inside as it gets. Man, it's tough to be sick, and then you put on top our crazy system. Everyone needs to see a psychiatrist."