Notes on the Care Innovation Summit

Kent Bottles MD

The Care Innovation Summit, Washington, DC, January 26, 2012

Sponsored by CMS, West Wireless Health Institute, and Health Affairs

Anyone who is concerned about the future transformation of the United States clinical delivery system should pay attention to the Care Innovations Summit.  The selection of presentations as well as the content that was discussed says volumes about where CMS believes payment is headed.  Speaker after speaker stated that decreasing the per-capita cost of health care and increasing the quality patients receive is the dominant political, social, and economic issue for all Americans.

Marilyn Tavenner, the new Acting Administrator for the Centers for Medicare and Medicaid Services, outlined what she saw as the major accomplishments of the past few years.  Her list included providing partial relief for 3.8 million seniors who hit the prescription drug “doughnut hole,” creating high risk pools for 45,000 Americans, creating a consumer website, allowing young adults to stay on their parents’ health care insurance until age 26, eliminating denial of coverage for patients with pre-existing conditions, eliminating lifetime and annual health care insurance maximums, increasing the coverage of many prevention measures, creating pilots to explore how to base payments on quality not volume, and getting the Innovation Center up and running.

Atul Gawande, MD, the Harvard surgeon and New Yorker author, presented the morning keynote.  Gawande, the author of three books on health care (Complications, Better, and The Checklist Manifesto), said the “cost of health care is destroying the American dream.”  In Massachusetts the state government sent nearly a billion dollars to local schools to pay for smaller class sizes and better teachers’ pay, but every dollar was diverted to covering higher health care costs.  For each dollar added to school budgets, the costs of teacher health benefits took a $1.40.

Continue reading “Notes on the Care Innovation Summit”

Atul Gawande, MD on Medicare Payment For End-Of-Life Counseling

In the wake of the Obama Administration’s retreat from allowing Medicare to pay physicians to counsel patients on their end-of-life options, here’s a short but powerful perspective by Atul Gawande, who wrote in depth last August in the New Yorker about how inadequate we are at helping patients negotiate death.

Gawande: Questions For Patients Facing Death

Here’s a 3 minute clip from Atul Gawande’s lecture at the New Yorker Festival in early October, titled “How To Live When You Have To Die.” I was extremely fortunate to be invited to be in that audience. It was not only informative and useful, but moving in a way and to a degree that exceeds any other professional presentation in my career. This taste provides some key information on questions worth posing to anyone facing death, but for anyone interested in the topic, I’d encourage you to invest $4.95 and an hour and a quarter, and watch the entire presentation here. I promise you that the experience will be well worth the investment.