Medicare, Medicaid quality plan unveiled

The Obama administration on Tuesday announced new initiatives to boost the quality of medical care that Americans receive, laying the foundation for what many experts think could be one of the most far-reaching benefits of the new healthcare law.

The 10-year, $10-billion effort — which proponents hope can reduce hospital-acquired infections, help ensure seniors take their medications, and more — has garnered far less attention than the politically charged debate about repealing the law.

But the quality-improvement campaign is quietly winning the support of corporate leaders, consumer groups, doctors and healthcare experts across the political spectrum.

At Tuesday’s kickoff, leaders from IBM, the American Medical Assn., the American Nurses Assn. and insurance giant WellPoint joined consumer advocates and administration officials in Washington to praise the program.

“This is a breakthrough,” said Andrew Webber, president of the National Business Coalition on Health, whose members represent some of the country’s largest employers.


The drive to improve the quality of medical care comes amid mounting evidence that patients are suffering in the current system — further driving up costs.

“The American healthcare system is not currently performing the way it needs to. It’s broken,” said Dr. Donald Berwick, head of the Medicare and Medicaid programs, citing recent research suggesting that 1 out of every 7 Medicare patients who is hospitalized suffers harm from a medical error.

“We are spending a lot of money for a system that is too often fragmented and disorganized and fails to meet patients’ needs, despite the best efforts and the very strong intentions of clinicians and others who … try every day to do the best to meet those patients’ needs,” Berwick said.

The Obama administration’s new quality initiative focuses on improving care for the approximately 90 million Americans who rely on the government-run Medicare and Medicaid programs.

But in a change from previous efforts, Washington officials are working to partner more closely with the private sector to speed development of better systems for all patients.

Some critics of the healthcare law, including the U.S. Chamber of Commerce, have dismissed the latest quality-improvement effort. Chamber Senior Vice President Randy Johnson derisively described the initiative as “a lot of things up against a dartboard.”

But leaders of several major corporations have cheered the Obama administration’s moves to involve commercial health plans, businesses and others, including state leaders. And some companies are eagerly moving ahead in partnership with government.

“We have a great opportunity ahead of us,” Larry Becker, benefits director at Xerox Corp., told business leaders in Washington this week.

To begin the quality improvement push, a new Center for Medicare and Medicaid Innovation will work with physician practices in eight states to help primary-care doctors better coordinate the care their Medicare patients get throughout the medical system.

The states are Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota; several already have private-sector or state-led programs underway.

There is growing evidence that if doctors work more closely together, their patients are hospitalized less frequently, recover more quickly from illness and suffer fewer complications.

A similar effort by the new center will target hundreds of federally funded health clinics, which provide primary care to millions of poor Americans on Medicaid.

Next year, the center also will award $1-million grants to help states develop other programs to coordinate care and improve quality for poor seniors.

In coming years, administration officials hope the center will develop other initiatives to help doctors and hospitals, including expanded use of quality measurements.

“This is an important step,” said Dr. Mark McClellan, who headed the Medicare and Medicaid programs under President George W. Bush. “Even if there are big disagreements about the role of government … hopefully, we’ll find some ways to find bipartisan agreement to do some of the things that improve care.”