Department of Health and Human Services Secretary Michael Leavitt said HHS has no intention of slacking off in its efforts to drive transparency into the U.S. healthcare system during the winding down of the Bush Administration.
At the Fifth Annual World Health Care Congress, held Wednesday in Washington, D.C., Leavitt said in his 272 days left as HHS secretary he has "a continued sense of urgency" and plans on picking up the pace to drive much-needed change.
"I am among those that believe our unbridled healthcare costs will bring our economic system to its knees," he told healthcare executives attending the conference.
Among initiatives in the works, Leavitt said HHS is consolidating all healthcare quality standards used across its agencies and will publish them in an effort to boost their market-wide use. Many standards have been developed over the past few years, but they aren't being developed fast enough, he said.
HHS is also experimenting with competitive bidding for bundled services, beginning with a Medicaid demo that HHS officials hope to expand in the future, Leavitt said.
The Bush value-driven healthcare plan relies on healthcare IT adoption to record quality measures and aggregate and provide cost and quality information to consumers, but adoption by small physician practices remains at 10 percent, Leavitt said. HHS plans in June to push Congress to tie physician Medicare payment incentives to the use of healthcare IT. Leavitt pushed for this in December, without success.
Leavitt said HHS will push this year for the mandatory use of electronic prescriptions for Medicare and Medicaid and will campaign to promote widespread use of personal health records (PHRs). Consumers will want their PHRs to be populated by providers, he said, thus encouraging provider uptake of healthcare IT.
Waiting for the government to pay for healthcare IT is not a plausible idea, said Leavitt. He noted Internet adoption is not being funded by the government, but the market is pushing its use.
Leavitt called the Bush value-driven healthcare initiative a "big-picture workplan" that will take more than a decade to accomplish. Any effort made to move it forward before the end of the year will help lay important groundwork, he added.
The Bush value-driven healthcare reform plan is based on the use of healthcare IT to record measured quality, the transparency of pricing and quality to consumers and payment to providers based on value.
"The billing system we use is insane," Leavitt said. Unlike any other facet of the economy, he said, healthcare requires consumers to purchase a service without knowing the price.
Leavitt said U.S. healthcare reform will be impossible without reforming its biggest payer – Medicare. Medicare pays for some 52,000 knee replacements a year, yet patients have no idea what the total cost of a knee replacement is, nor do they know the value of the care they receive, he said.
If consumers could get a single price for all the costs related to a treatment, such as a knee replacement, it would keep providers from gouging, Leavitt said, and the market would be the enforcer of value-driven care.