As her tenure as secretary of Health and Human Services comes to a close, Sylvia Mathews Burwell looks back on what the White House administration has accomplished in terms of healthcare quality, costs and data and what the future holds for healthcare transformation.
In the last two-and-a-half years since she took office, Burwell has become the public face of the Affordable Care Act and defender of President Barack Obama’s signature legislation.
Despite fears that the healthcare gains made under the White House administration will roll back under President-elect Donald Trump and a Republican-controlled Congress, Burwell writes in a blog post for Health Affairs that healthcare transformation is larger than any one administration.
“The Affordable Care Act may have been an important catalyst, but the changes it set in motion are permanent. And were well overdue. Any attempts to reverse or legislate away this progress will have to grapple with the reality of what our nation has already achieved,” she writes.
Those achievements, she says, include:
- Insurance coverage for more than nine out of every 10 Americans
- Spending less on healthcare (based on projections from the Centers for Medicare & Medicaid’s Services’ Actuaries that the U.S. will spend $2.6 trillion less on healthcare services for much of this decade than originally projected prior to the passage of the ACA)
- An aggressive shift away from fee-for-service to value-based healthcare, particularly progress in cost savings and quality of care delivery under Medicare ACOs and passage of the the bipartisan Medicare Access and CHIP Reauthorization Act (MACRA)
- New payment models, such as bundled payments for joint replacements and a new advanced primary care medical home model
- A huge increase in the number of hospitals that have adopted electronic health record systems
- A firm commitment from the companies that provide 90% of EHRs used by American hospitals to improve the flow of health information
Despite the challenges ahead, Burwell believes that achieving the goals of the Triple Aim—improved healthcare quality and access for less cost—is possible. “It’s a national imperative, one we’re working on right now, and one future policymakers would be keen to follow,” she writes.