Centers for Medicare and Medicaid Services Administrator Donald Berwick, M.D., used his Thursday keynote at HIMSS11 to laud the myriad provisions of the Affordable Care Act, saying the reform bill ushers in the end of the “hunter-gatherer search for information” days we currently live in.

Berwick said health reform at its heart addresses three pillars of the new care model—making a plan, acting as a team, and putting the patient in charge. The tectonic plates of health care are shifting, he said, and while that’s creating a great deal of anxiety and confusion in the health industry and general population, don’t blame the legislation.

“The Affordable Care Act is not changing the conditions; it’s a response to the changing social conditions … patients, especially Baby Boomers, demanding more medical accountability, the medical game being embedded in the social context of a service environment that requires transparency and responsiveness, and health care being inexorably tied to our national economic condition as well as the global economy.”

Berwick went on to say that health reform removes the “Sword of Damocles” hanging over the heads of the uninsured and citizens with pre-existing conditions who cannot get insurance, and gives federal officials the tools to address some of the most glaring weaknesses in the market. Tucked into the massive bill, for example, is funding for the Federal Coordinator Health Care Office, which is analyzing the care provided to the 9.2 million U.S. citizens who have dual qualification for Medicare and Medicaid. “That group, which is relatively small, accounts for more than 40 percent of state Medicaid expenditures, and we estimate that only 100,000 are receiving any type of coordinated care.”

The Medicare Innovation Center also came up. The center, which has $10 billion in funding from the health care reform law, is tasked with funding programs and technologies that provide lower cost care “while not harming a hair on anyone’s head,” Berwick said, adding that he considers the innovation center “the jewel in the crown of the Affordable Care Act.”

Berwick also said that his office was planning to “imminently” issue a notice for proposed rule-making for accountable care organizations. He also noted, after peppered with questions, that ACOs will operate in the context of Medicare’s fee-for-service program, and will not be a rehash of a managed care model. Berwick also noted that ACOs were just one new care model being rolled out via health reform, ticking off medical homes, health homes and bundled payments as examples of other models CMS is authorized to develop.

He also told audience members that CMS will soon roll out a “major” patient safety initiative that will address healthcare-acquired conditions such as pressure ulcers and central-line infections. Berwick did not provide more specifics about the program.

 --Greg Gillespie

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