6 policy reforms to improve U.S. healthcare

Leaders from across the industry have identified six "common-sense solutions" to improve the U.S. healthcare system, touching on subjects including data interoperability, Medicare payment policies and care of chronically ill patients, according to a report released Wednesday.

Working on behalf of the Healthcare Leadership Council's (HLC) National Dialogue for Healthcare Innovation initiative, the group of industry leaders included Premier Inc. President and CEO Susan DeVore; Andrew Baskin, M.D., Aetna's national medical director for quality performance; and Christi Shaw, Novartis Pharmaceutical Corporation's president and head of U.S. General Medicines.

In developing the six steps, the industry leaders sought to identify reforms that they believed could draw support from both parties even in a politically charged election year, according to a statement emailed to FierceHealthcare.

"These steps aren't revolutionary, but they are transformative," said HLC President Mary R. Grealy. "There are viable, practical, common-sense solutions that can and should be implemented to help make our healthcare system more patient-centered and effective."

Here's an overview of the six steps:

  • Set a "firm date"--Dec. 31, 2018--to achieve health information interoperability everywhere in the U.S., with the private sector leading the way to help healthcare organizations share data. This parallels the goal set forth by the Medicare Access and CHIP Reauthorization Act (MACRA), the report notes.
  • Implement reforms to improve the Food and Drug Administration, including easing administrative burdens imposed on the agency and taking steps to more quickly deliver innovative treatments and technologies to patients.
  • Implement "best practices" for Medicare, insurers and healthcare providers to improve all aspects of care for chronically ill patients. Specifically, the report outlines a set of comprehensive care planning principles using diabetes patients as an example.
  • Reform outdated physician self-referral and anti-kickback statutes, and expand Medicare payment waiver policies in order to encourage care coordination while preventing fraud and abuse. Congress has already set its sights on making changes to the Stark law governing physician self-referral following MACRA's passage.
  • Standardize the nation's privacy laws on the state and federal levels, and improve access to patient data for research. For example, the report notes that "one particularly burdensome barrier to nationwide health information exchange is the many diverse state laws across the country regulating health information alongside HIPAA." The Office of the National Coordinator for Health IT, has argued HIPAA does not impede interoperability.
  • Improve the Centers for Medicare & Medicaid Services' Enhanced Medication Therapy Management (MTM) Model, including allowing participating plans to help develop the quality indicators that comprise the uniform set of MTM data elements, and employing a public comment process that allows a full range of stakeholders to provide input into the final measure set.

The HLC has already started to meet with lawmakers to discuss the group's policy recommendations, Grealy said in a statement.

To learn more:
- read the report (.pdf)