Meg Marshall, senior director of public policy for Cerner, develops and oversees Cerner’s legislative agenda and represents the interests of Cerner and health care IT collaboratives in working with government officials and industry partners.
The 2016 presidential debates have focused on many important issues like national security, immigration, the strength of the economy and foreign policy. The topic of health care has been touched lightly, through a lens focused on the candidates’ positions regarding the Affordable Care Act. During the second presidential debate, we heard Secretary Hillary Clinton address how she would build on and improve the Affordable Care Act, and Donald Trump described a repeal-and-replace strategy that would block grant Medicaid and allow insurers to sell plans across state lines.
Both candidates agreed that health care is too expensive. The U.S. government spends $3.2 trillion each year on federal health programs, including Medicare and Medicaid. This is more than what is spent on Social Security, defense or any other programs, and it’s projected to reach $4 trillion by 2020.
As the health care industry continues to focus on increasing quality while reducing cost, technology plays a foundational role. Health IT not only directly helps caregivers interact with patients, but the data collected from our systems can reveal actionable insights that could identify new strategies and interventions.
As such, it is surprising that health IT has not received coverage in the debates or on the campaign trail.
The next president will need to fill approximately 4,000 appointments, of which approximately one-quarter require Senate confirmation. Appointments include members of the Cabinet, White House staff and top policy and management positions at each federal agency. The top 100 leadership positions, including the Cabinet secretaries, will be filled soon after inauguration. For this reason, the candidates have already started identifying and vetting next steps for key agencies, based on needs and issues. To some degree, we can predict priorities for the next administration, however, we continue to wait for signals from the candidates on their plans for several important areas:
The health care system needs to continue investing in the flow of health information among providers where and when it is needed. Nationwide interoperability will help providers make more informed care decisions, and it will lead to more connected care across the continuum, resulting in fewer unnecessary treatments and more targeted care at the right time.
Consumer-oriented technology, including health and wellness apps and devices, will have an increased role in our day-to-day lives. As our population becomes more mobile, accessible and connected, patients will seek convenient access to care through tools similar to what they use on a daily basis, and providers will look for innovative ways to reach patients outside of the traditional care setting. Apps and smart devices will enable individuals to engage in their health care journey and become better informed and up to date about their health conditions. Advancements like telehealth, remote patient monitoring and the Internet of Things will help patients recover at home and avoid lengthy inpatient stays. We hope to see the next administration support continued innovations in the private market and commit to eliminating existing barriers.
The U.S. has invested over $35 billion since 2008, when Congress passed a law intended to encourage hospitals and physicians to use electronic health records (EHRs). Today, nearly 85 percent of all physicians and 95 percent of all hospitals have EHRs. The industry is just beginning to realize the powerful role that the vast amount of collected patient data can play in discovering breakthroughs in medical science. Now is the time to focus our energy on leveraging technology to transform the delivery of care and the discovery of new treatments and cures. Continued funding for research, such as the Precision Medicine Initiative and the Cancer Moonshot, will speed progress and provide expanded access to advanced therapies.
Reimbursing providers based on quality and efficiency, not quantity, is another critical strategy to curb the costs of health care while working toward improved overall value. As the largest payer in our health care system, the federal government wields a huge influence on how health care is paid for and delivered. In 2015, the Secretary of Health and Human Services, Sylvia Burwell, set goals to tie half of Medicare payments to quality or value through alternative payment models by the end of 2018, and 90 percent of Medicare fee-for-service payments by the end of 2018. The Centers for Medicare and Medicaid Services is advancing additional innovative payment reforms, such as operationalizing the Medicare Access & CHIP Reauthorization Act of 2015 and increasing bundled payment programs.
In the years ahead, Cerner and our clients can expect significant legislative and regulatory activity that have consequential effects on the health care industry. Regardless of who our next president will be, Cerner seeks thoughtful engagement from the potential future administration to ensure that health IT is leveraged to safely improve quality of care for patients and entire populations, improve value, and engage patients and families.