Every year at the annual HIMSS Conference, there is talk, there is buzz, there is a Zeitgeist. Well, HIMSS15, held in Chicago, set a new standard for clarity and consistency. For, as attendees dashed from presentation to presentation, meeting to meeting, it seemed patently clear where healthcare and healthcare IT were headed. In contrast to, say, ten to 15 years ago, where one had to thoughtfully parse all the predictions and prognostications, there was no ambiguity or vagueness this time. Indeed, the signs and signals this year were as clear as the ginormous banners hung in the main foyer of the vast McCormick Place Convention Center, where the conference was held, welcoming 43,143 attendees, as of Thursday morning, an all-time record. Yes, everything about HIMSS this year was big—really big.
There were numerous appearances by federal healthcare officials, not only from ONC (the Official of the National Coordinator for Health IT), but also from CMS (the Centers for Medicare & Medicaid Services), and their overarching agency, HHS (the Department of Health and Human Services). And those federal healthcare officials couldn’t have been clearer in their pronouncements.
Most stark of all was the address by Andy Slavitt, Acting Administrator for CMS, as part of the closing keynote session held Thursday morning, April 16. Slavitt, who addressed an audience of about 4,000 attendees, immediately following a speech by Karen DeSalvo, M.D., the National Coordinator for Health IT, made it absolutely clear where he and other federal officials intended for the U.S. healthcare system to go in the next several years.
“Our priority is simple,” Slavitt told his audience: “to drive a delivery system that provides better care, smarter spending, and keeps people healthier. The success in the first five years since the Affordable Care Act has been very encouraging,” he said. “We’ve moved lack of insurance from 20 percent to less than 13 percent. We’ve reduced patient harm in the last four years in hospitals by 17 percent. And we’re not doing this by breaking the bank. Health inflation is at its lowest rate of increase in four years. Our agenda now,” he said, “is to get busy strengthening these gains. That will mean that more providers in more communities will need to be able to transform the care they provide so that they will benefit from value-based reimbursement. And they will need technology to help them get there.”
Slavitt cited three key goals he wanted CMS to help providers accomplish in the coming years. “One, care providers and patients should begin to feel the benefit from all that investment in care technology, what I call the care dividend,” he said. “Second,” he said, “we have a great need for a more modern infrastructure in healthcare. For the healthcare industry to become truly as great as we deserve… we need a Moore’s law effect in healthcare productivity to care for our dual-eligible patients and aging Baby Boomers, and we need technology to do that. I think we could do with a little less emphasis on shareable and wearable and more infrastructure emphasis.” In that regard, he cited new grants coming out of CMS for technology investments by state Medicaid programs. With regard to what Medicaid programs and other initiatives need, he said, “We need off-the-shelf, easy-to-maintain, modular systems that are faster to stand up and use.”
Importantly, Slavitt added that “We are moving to a place where it’s not about adoption of technology, but where, when you are walking the halls of a clinic, are patients feeling the improvement, and are caregivers feeling the improved productivity? The good news is that we have momentum, but I fear that if we don’t get very urgent about it, it won’t move fast enough.”
Honestly, it doesn’t get much clearer than that. Slavitt even referenced the statement of intention that Health and Human Services Secretary Sylvia Mathews Burwell had made back in January, when the Secretary had said she wanted to see 50 percent of Medicare fee-for-service reimbursement being paid out via alternative payment models such as accountable care organization (ACO) or bundled payments, within three years. That is an exceptionally ambitious goal by any standard; and as we at HCI had reported back in January when Mathews Burwell made her statement, there were several other goals embedded in the same statement. The HHS Secretary had called for 30 percent of all traditional Medicare payments to be tied to form of quality-driven or value-based payment by the end of next year. She had also said she wanted 90 percent of Medicare payments tied to some form of alternative payment by 2018.
(And, fortunately, right in the middle of HIMSS, the U.S. Senate passed, and then President Obama signed, the SGR repeal legislation, freeing healthcare from the long shadow of the SGR patch ongoing nightmare, while simultaneously, that legislative development added to the overall policy clarity by creating an entirely new physician payment incentive program that will revolutionize doctor incentives nationwide in the coming decade.)