Berwick: Healthcare can't undo reform changes

As the industry waits for the U.S. Supreme Court to uphold or repeal the Patient Protection and Affordable Care Act later this month, former Centers for Medicare & Medicaid Services Administrator Donald Berwick said the U.S. healthcare system will never go back to a pre-reform state, no matter the ruling.

"There is so much tectonic motion now--the plates are shifting--and I don't think they can go back," he said in an interview with The Guardian.

Health reform already has fueled major changes, with the industry seeing an explosion of hospital-physician employment agreements and more accountable care organizations coordinating high-quality, low-cost patient care, he noted.

Moreover, regardless of the Supreme Court ruling, hospitals already have been updating policies and procedures to adhere to reimbursement changes that would kick in under health reform, implementing hourly patient rounds and home-based care programs to cut hospitalizations emergency department visits.

Berwick said if the Supreme Court does act, it may only rule against the individual mandate. However, he worries that any changes to the law would hurt poor and disadvantaged patient populations, according to the article.

"If you don't get the kind of reforms in healthcare on quality and continuity and patient centred-ness that the ACA progresses in Medicare and Medicaid, then the poor will get hurt, and we're really on a knife edge on that one," he said.

In his first appearance before Congress after his highly criticized recess appointment as head of CMS in 2010, Berwick told a Senate panel that repealing healthcare reform legislation would be a big mistake.

Similarly, U.S. Health & Human Services Secretary Kathleen Sebelius last year called repealing health reform a "huge step backward." Scrapping the legislation would not only deny coverage to 32 million Americans but also add a trillion to the deficit over the next 10 years, she said.

To learn more:
- here's the Guardian interview