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Exploring Options to Fund Health Care Reform: The Role of Health IT

Today, I had the opportunity to join the Alliance for Health Reform for their briefing entitled “Scoring Savings: How Can Quality Improvement Reduce Health Care Costs?” along with panelists Len Nichols, Director of the Health Policy Program at the New America Foundation; Simon Stevens, Executive Vice President of the UnitedHealth Group and Chairman of the UnitedHealth Center for Health Reform and Modernization; and Gail Wilensky, Senior Fellow at Project Hope.

The panel was moderated by Ed Howard, who has led the Alliance–a Washington tradition–for many years. Since 1991, the Alliance for Health Reform has served as a source of unbiased information to help policymakers, their staff, journalists and advocates understand the rapidly changing environment, hosting more than 200 forums in Washington and around the nation.

Panelists offered their insights regarding the current policy dialogue on finding savings and slowing the growth curve in health care. I shared several of the strategies that IBM–which provides healthcare for more than 450,000 employees, retirees and dependents–has utilized to both improve health and health care while also reducing costs. Key strategies outlined in my presentation included the following:

1. Providing incentives to individuals to help them make healthy choices, including participating in a physical activity or a nutrition program, or executing on a preventive care plan.
2. Focusing on prevention and value in medical care, including offering free coverage for preventive care, no deductible for primary care, and considerable support for those with chronic conditions.
3. Providing a number of personal electronic management tools to help individuals navigate their health and health care.
4. Promoting quality with health plans with which we do business and practicing good purchasing policy.

Many of the strategies outlined above, which are often adopted by private employers, can also help the federal government reduce its own health care costs, contributing to the costs of covering the uninsured.  Click here for a copy of the full presentation shared during the Alliance for Health Reform briefing.

Many of the strategies contemplated for health care reform–including much of what’s outlined above–cannot happen effectively without a strong foundation of information which can only be enabled by information technology.  A platform which enables connectivity and the exchange of health information–while effectively managing patient privacy–among patients, providers, and those responsible for population health is crucial for achieving much-needed benefits in the quality, safety and efficiency of our health care system. Such an informational foundation can not only support health care delivery–getting the right information to the right place at the right time, but also critical population health goals, including improving performance, detecting and responding to both medical product safety and public health threats, and learning more about what works and doesn’t work in health care.

During the week of June 29, 2009, I had the great pleasure of working with colleagues at the eHealth Initiative, MIT, and Healthcare Conference Administrators, who hosted the HIT Symposium at the Massachussets Institute of Technology in Boston, MA.

The Symposium included some of the best presentations I’d heard in a long while in the health IT arena, including presentations from HHS National Coordinator for Health IT Dr. David Blumenthal, AHRQ Director Dr. Carolyn Clancy, and Clayton Christensen.

Of great interest was the common theme that rang throughout the program….that unprecedented investments of $36B in health IT should focus on improvements in the quality, safety and efficiency of health care–and that health IT is not an end unto itself. This is very consistent with the mantra of the non-profit, independent, multi-stakeholder eHealth Initiative, when I was at its helm as its CEO from its founding to April 2009 of this year.

I had the privilege of providing an overview of the American Recovery and Reinvestment Act and some of my own insights regarding how health IT policy should evolve at the beginning of the conference, before Dr. Blumenthal made his keynote remarks.

Dr. Blumenthal and his colleagues at HHS have an enormous responsibility, which we understand–based on his remarks at MIT and in all of his public comments–he does not take lightly. Effectively accelerating the adoption of health IT, but doing so in a way that enables innovation and most importantly, assures that U.S. citizens will derive the benefits–which include improvements both in care delivery and population health–is no easy task. But this is clearly a task that he is up to.

His significant understanding of health policy, his openness and willingness to listen, his ability to move the status quo, and most of all, his strength of conviction for and relentless focus on health and health care improvement as the goal, will enable him to effectively navigate the complexities and the myriad of stakeholder interests, to get to thoughtful and effective strategies for improving health and health care through the use of IT. An online video presentation is available from the HIT Symposium web site.

During my remarks at the Symposium, I highlighted some of my own key insights as input to the Administration as it creates its strategy and path forward for health IT:

1. Meaningful use should focus on rewarding improvements in health and health care, and then providing the informational foundational to support those improvements. This would include the sharing of information to support care delivery decisions and population health goals including laboratory test results, medication-related information, and other key data elements.
2. With the right incentives in place, and clarity around a national set of standards (including a clear timeline for future roll-out), several innovative approaches for helping providers achieve meaningful use can and will occur.
3. Incentives are needed not only to support higher quality, more efficient care delivery, but also the use of such information (while effectively protecting patient privacy) to support improvements in population health including those related to better care coordination, performance measurement for improvement, medical product safety, public health, and understanding better what works and doesn’t work in healthcare.

Click here for a copy of my presentation.