A lot is going on in Washington around reform every day. I had a chance to talk with Speaker Nancy Pelosi (D-Calif.) last week, and she is truly eloquent in terms of her ability to summarize the various changes needed to improve the American health care non-system. She knows her stuff. From her point of view, the SGRrrr still has to be eliminated this year (encouraging). She believes universal coverage will be achieved, and she’s very excited about ACC’s proposals to reduce unnecessary readmissions and to use quality of care and the NCDR to reduce morbidity and mortality, increase evidence-based care, reduce disparities, and improve effectiveness.

ACC President Fred Bove and I talked with Rep. Nathan Deal (R-Ga.), House Energy and Commerce Minority Leader. He is also interested in quality and wants the Republicans to be players in delivery system reforms. He thinks the Democrats are trying to lock them out of the reform process. He’s also interested in malpractice reform and asked Fred Bove and me to get him more information, not only on our Quality First agenda, but also on how we might advance tort reform in the big system reform process. 

Physician, Health Plans: Can Agendas be Aligned?
Karen Ignagni, CEO of America’s Health Insurance Plans, and I talked last week about their concerns and key issues in reform, and how we might align our agendas. Obviously, AHIP doesn’t want to see a “public plan” that would compete head-to-head with private insurance as part of the solution. But she does understand the protective value of having insurers and physicians working together on payment reforms that would both improve quality and also improve the bottom line of beleaguered practices, noting that insurers have not very often been on the “good guy” list in these regards of late.

I do think there may be a lot more in common in the near future between physicians and health plans as reform progresses. We’re both targets for savings. The most viable kind of payment reform would result from gainsharing relationships where doctors get credit for improving the system. Patients are the primary beneficiaries, and insurers share in some of their resulting increased profits. As quality and effectiveness improve, so should the insurers’ bottom line. It could be different for hospitals in this regard.

*** Image from Flickr (cormac70). ***

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