Health Reform & Hospital Medicine

By  |  October 2, 2009 | 

Rob Bessler wrote…

I had the honor representing both Sound and the Society of Hospital Medicine on a visit to the White House last Thursday to meet with the Policy Director for the Obama Administration on Health Reform in the Office of Public Engagement, Kavita Patel. We then met the Chief Medical Officer for the Department of Health and Human Services, Dr. Patrick Conway. Dr. Conway will have the responsibility under the Secretary to help deploy $850 billion dollars in the proposed bills.  We expressed our support for driving improvements to quality at a lower cost. Our agenda and time was primarily focused on offering up our collective knowledge as the bill takes shape.  We want to be seen as a resource.  SHM and Sound in particular have tremendous intellectual resources from its chiefs, team members and management along with our robust data generated by deploying its model of clinical process excellence to drive performance.   I gave many examples of what Sound can do including  our Sound Transitions ProgramTM calling both patients and pcp’s after discharge, and the dramatic impact it can have.

I personally expressed my concern with the bills before both the House and Senate currently not addressing access to actual care.  All 5 bills to date focus on access to insurance and I personally expressed for more meaningful attempts at bending the cost curve which the CBO states none of the current bills truly address. Without addressing cost, we are just putting off the difficult task until the next crisis similar to our financial crisis we just experienced.  We expressed support for tremendous need for payment reform.  Our nation is achieving results of ever increasing cost without demonstrated improvements in quality because our system rewards only the volume of care. The needed changes to pay for quality vs just volume and a shift towards primary care incentives to drive our medical school graduates into the fields to keep people more healthy are limited in the current bills. We all see the daily challenges of our patients coming in sicker due to no outpatient care and then no place to send them after discharge. The current House bills call for a mere 10% increase payment for primary care. I expressed concern that a mere 20k per year won’t shift graduates into primary care vs the high six figure salaries for the most lucrative fields. I also expressed my personal desire to see more patient accountability for their health vs the Nations accountability for just providing health insurance. Based on the national debate to date, this issue appears off limits in the discussion at both the house and senate due to the politics involved.

Below is an email some of you may have received from Larry Wellikson, the CEO of SHM, who joined me for the visits. We are asking for you to contact your representatives to express your views and support improving quality at a lower cost as a recurrent theme. There has been no more exciting time in healthcare. Sound is at the fulcrum of opportunity to make dramatic improvement in the care of our Nations sickest patients and help improve the sustainability of our Nations Acute and Post Acute Care healthcare partner facilities.  Please take a minute to express your views. My greatest frustration and fear is that so much energy and ultimately  money will be expended in this “push” to get a bill out before the next election cycle in  both the Senate and House, without taking the necessary action to truly improve quality outcomes, cost of care and access for all Americans.

To SHM’s Leadership – A Message from your CEO

Dear SHM Leadership-

We need just 10 minutes of your time to make sure the voice of hospital medicine is heard in Washington. I just got back from key meetings in DC at the White House and with the Department of Health and Human Services and now is the time for you to help SHM continue to be influential in the health care reform debate.

Recently, you received a communication from Eric Siegal, MD, FHM, Chair of SHM’s Public Policy Committee, asking that you urge your lawmakers to work together on a much needed overhaul of our health care system.  This is a historic opportunity that we must take advantage of and support in order to see meaningful, comprehensive health reform.

Though the legislation remains a work in progress, the good news is that the bills thus far reflect many of our high priority goals:  SHM is committed to working with Congress and the administration to implement reforms that increase access to health insurance coverage; improve the safety, quality and value of health care services; and control rapidly rising costs. As the leading voice for America’s hospitalists in our nation’s capital, we ensure that the values of hospital medicine are represented on Capitol Hill, particularly when it comes to improving inpatient quality and reforming the delivery system.

I am writing to ask you, as not only the leaders of SHM but within the hospital medicine specialty as a whole, to take just a few minutes out of your time and visit our Legislative Action Center where a sample message is available for you to personalize and email to your representatives.

If you’d like to review SHM’s Principles on Health Reform, the September Washington Update, or recent letters to Congress for background on where we stand, visit the Advocacy section of the website.
Act NOW. It is important and it does matter.

I appreciate your efforts and support.  As always, I’m available to discuss this issue further if you have any questions or concerns.

Thank you,

Larry Wellikson, MD, FHM
Chief Executive Officer

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