*/
Here's the latest reason to be depressed about the state of U.S. healthcare.
It appears that the highly qualified Donald Berwick, MD, will not be confirmed by the U.S. Senate to serve as director of the Centers for Medicare & Medicaid Services.
Berwick, the founding head of the Institute for Healthcare Improvement, has worked at the job since President Obama installed him at CMS last year via recess appointment. Unfortunately, he made the mistake of speaking frankly about the deficiencies of the U.S. healthcare system and how we might learn from other nations that have superior patient outcomes but spend less money. He's become a victim of the political battles playing out over the Accountable Care Act, rather than being assessed on his contributions to care quality and cost control.
While the Berwick fiasco is reason to be disappointed in the direction U.S. healthcare is heading, if you venture deep enough into the weeds, you can see some positive trends.
The Standard & Poor's Healthcare Economic Composite Index for 2010, released in late February, indicates that the average per capita cost of healthcare services rose slightly more than 6 percent. Why is a rise in healthcare costs a good thing? Well, not every increase is the same. The February S&P Composite Index marked the seventh consecutive month in which a deceleration in the annual rate of change was measured.
Thus, healthcare costs may still be rising, but at a more moderate pace. The annual rate of change is down 2.68 percentage points from a peak in May 2010 and down 2.10 percentage points from its December 2009 rate.
The S&P Composite Index combines data from the firm's Commercial and Medicare indices. It estimates the per capita change in revenues accrued each month by hospital and other provider facilities for services provided to patients under traditional Medicare and commercial health insurance programs.
David Blitzer, chairman of the index committee at S&P, said the year-end report shows that the trend of slowing annual growth rates in healthcare costs that started in early/mid-2010 continued through the end of 2010.
"The Commercial Index was up 7.75 percent and the Medicare Index up 3.27 percent in December 2010, both displaying deceleration similar to the Composite Index," Blitzer said. "As we've seen through most of the indices six-year history, the rate of change in expenditures associated with commercial health insurance plans continue to significantly outpace expenditures for Medicare."
Compared to May 2010, the Commercial and Medicare indices are down 2.13 and 3.57 percentage points, respectively. For the Medicare Index, the annual growth rate has been reduced by more than half its rate posted in May.
"The Composite Index reached rates last seen almost four years ago, in the summer of 2007," Blitzer said. "The Medicare Composite, however, did reach a new low of plus-3.27 percent in December 2010 – the lowest annual growth rate in the six-year history of the index." Blitzer also revealed that the S&P Healthcare Economic Hospital and Professional Services indices showed a similar moderation in the rate of increase of annual growth rates. Hospital and Services indices posted rates of increase measuring 5.60 percent and 6.34 percent rates for December 2010, respectively, versus May 2010 rates of 7.99 percent and 9.33 percent.
So, is this the height of desperation, seeking solace in a slower rate of cost increases?
Perhaps so, but in an environment where someone like Donald Berwick can be hounded out of Washington for competence and honesty, you take solace where you can get it.