The Republican leadership’s ACA repeal bill is dead for now, but quality of care in the U.S. is still at risk. In an interview for KPBS.org, Donald Berwick, M.D., president emeritus of the Institute for Healthcare Improvement and former head of the Centers for Medicare and Medicaid Services, explains the importance of ACA initiatives to improve health care quality. Even without ACA repeal, there’s reason for concern that the Trump Administration will give these initiatives short shrift.
As head of the department of Health and Human Services, Tom Price could do a lot to undermine the quality improvement programs included in the Affordable Care Act. Will Secretary Price, for example, honor the ACA’s requirement that government collect health care data, develop evidence-based measures of health care quality, and give people a better understanding of differences in care provided by doctors, hospitals and nursing homes? Will the Trump Administration promote health care transparency or leave us in the dark when doctors and hospitals perform poorly, putting patients at risk.
Beyond supporting systems for measuring and reporting quality of care, what will become of ACA-funded initiatives that promote significant quality improvements among doctors and hospitals? For example, the ACA’s $500 million Partnership for Patients helps reduce hospital-acquired conditions, such as pressure ulcers people get in hospital from not moving, and blood clots. According to Berwick, that initiative alone has saved “tens of thousands of lives and billions of dollars.”
Similarly, Medicare’s hospital five-star rating system and financial penalties on hospitals that performed poorly on certain quality measures, (for example, hospitals with high readmission rates within 30 days of patients being discharged or with high numbers of patients acquiring infections unnecessarily,) have helped to promote better care. And, they have helped Americans appreciate that some hospitals perform better than others. Will the Administration dedicate needed funds to these programs?
The Republican leadership has not shown much appreciation for the value of health care transparency and incentives to drive quality improvements. How far backwards will they push our health care system even without ACA repeal?
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