Value-Driven Health Care System Coming, Says HHS' Leavitt

The value of health information technology in helping transform America's health care system was highlighted in a keynote address delivered by HHS Secretary Mike Leavitt at the Third Annual HIT Summit on Sept. 26 in Washington.

"We have the opportunity with interoperable health information technology to dependably measure price and quality in health care. That adds up to value and is critical to changing America's health care system," said Leavitt.

"Change is clearly coming," he added. "It has to."

According to organizers, the summit drew hundreds of national, regional and state health care decision makers to Washington to discuss current policies related to both health care quality and health IT. Those policies are emerging from federal and state governments, as well as from the private sector.

Co-sponsors of the summit included the AAFP, eHealth Initiative, Bridges to Excellence, AMA and American College of Physicians.

Leavitt said health care in America needs to be reorganized into a system of value-driven competition derived from a combination of price and quality.

"There are very few people in the United States who know the cost of their health care," said Leavitt. And most people don't care about the cost of their health care "because someone else is paying for it." As for quality, "in our society, it's impolite to ask about quality," he said.

"People need to know the cost, but they deserve to know the quality," of the health care they receive, he added.

Leavitt said the four cornerstones that must be in place to anchor the health care system of America's future are

America's health care landscape changed dramatically on Aug. 22, said Leavitt, when President Bush signed legislation that aims to change the way the federal government procures and pays for health care. Those changes embrace the four cornerstones.

The president's announcement was significant, because "the largest payer hasn't been at the table," said Leavitt. "The federal government, including Medicare, Medicaid and the VA (Department of Veteran Affairs) makes up 46 percent of the marketplace," he said.

Significantly, large employers also are becoming involved in the effort because they want to secure high quality health care for their employees at a cost that is less than what's currently available. The marketplace is beginning to organize itself around those same four cornerstones of connectivity, quality standards, cost comparisons and incentives, said Leavitt.

Lastly, the providers of care, the physicians, have become engaged in the effort. The physician community is helping develop quality measures for the care they provide "because the physicians want to do a better job for their patients," said Leavitt.

He predicted steady progress toward the end goal of a restructured American health care system. "Within five years, the term 'value' will have earned a place in the lexicon of American health care. In 10 years, the system of value-based competition will be in place," he said.

The United States will not remain prosperous in the global marketplace if it doesn't develop a sustainable health care system, said Leavitt. "We're engulfed in the kinds of problems that, if allowed to continue without change, could have a Draconian impact on this country."

This challenge can be handled in one of three ways: "fight and fail, accept and survive, or lead and prosper," said Leavitt.