How CMS is Changing Healthcare Dynamics

The Centers for Medicare and Medicaid Services has been working continuously with public and private partners to improve present healthcare service models to deliver better results and make the population healthier. Reducing cost is the primary objective, and investing more time in identifying gaps in current practices will help spend dollars intelligently.

The first step in realizing long-term goals of population health is to replace traditional payment models with value-based care, where providers are expected to document every step of the practice, bringing in transparency and accountability.

The purpose of ACA (Accountable Care Act) is to make quality healthcare affordable for all, including patients with pre-existing medical conditions.

Though it is a challenge to upturn the functioning of the healthcare system in a short span, a systematic approach can help achieve the end goal.

Medicare has been quick to come up with a strategy to promote the value-based purchase. About 30% of Medicare payments are expected to be tied to quality metrics through alternative payment methods by the end of this year, and nearly 50% in less than 2 years.

Priorities of National Quality Strategy

According to CMS, the following six aspects are prioritized highly by the NQS:

1. Making care safer by reducing the harm caused in the delivery of care

2. Ensuring each person and their family members are engaged as partners in their care

3. Promoting effective communication and coordination of care

4. Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease

5. Working with communities to promote wide use of best practices to enable healthy living

6. Making quality care more affordable for individuals, families, employers, governments, and communities by developing and spreading new health delivery models.

Minimizing Healthcare Errors

Healthcare related errors are hazardous and could end up curtailing the ambitions of NQS. According to CDS, nearly 1.7 million people are affected by errors due to adverse medication events, sometimes even leading to mortality. The cost involved in treating patients affected by errors are estimated to be $5 billion annually.

While the U.S. healthcare system is considered well-funded, with billions of dollars in spending, the results realized through investment has never been appealing. Countries whose healthcare expenditure is much lesser compared to the U.S., have accomplished better standards in attaining broader goals like population health.

It is alarming to realize the efforts and money spent so far are not sufficient in bringing change at the ground level. It’s high time we reconsider our approach and change the way we look at problems in the healthcare space. Reducing cost cannot be the only priority going forward, since reducing errors that impacts positively on care quality has proven to be of equal importance.

Nearly 70% of healthcare professionals have admitted to not being able to leverage the best of technology. Errors can be minimized by leveraging technology to supplement human effort, reducing ambiguity in decision making and enhancing informed decisions.

Can Technology be a game changer?

In every industry, let alone healthcare, the utilization of Information Technology has changed the way they function. Challenges in healthcare are quite complex and unique by itself, with the need to consider multiple variables before coming up with an appropriate solution. The one-size-fits-all approach may not work here.

Traditionally, providers have been less inclined to initiate implementation of any new technology. Some of them have even come forward to test how predictive analytics could be of use to improve their results in practice. However, integration of a new system to the existing one has never been easy, with more than 50% of the deployments not yielding many benefits.

Healthcare professionals need to partner with a vendor with industry expertise, and experience who could provide responsive solution thereby increasing the probability of successful technology deployment.

A strong Health IT infrastructure, involving new age practices like patient tracking, setting goals and monitoring health status should be included in electronic health records. The system should be able to collaborate and gather information from different systems to generate unified reports with actionable insights on one dashboard.

CMS encourages innovations leading to the effective change in the healthcare space, and have made it a requirement for their partners to deliver along the chain of healthcare space to show progress in real value.

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