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Health reform can reduce costs, improve quality

Oct. 11, 2012

By Doug Boyd
ECU News Services

The Affordable Care Act offers the opportunity to increase the number of people who have health insurance while also forcing health care providers to improve their quality and reduce costs, according to a health care expert who spoke Oct. 10 at East Carolina University.

Dr. Don Berwick, former administrator of the federal Medicare and Medicaid programs, addressed an audience of physicians, students, administrators and others at the Brody School of Medicine.

The act, often called "Obamacare" by its critics, will help limit insurance company administrative costs, reduce reimbursements to hospitals where patients are readmitted and help make the health care system more seamless and integrated, he said. It will also reduce waste.

"One out of three dollars we spend doesn't help anyone at all," Berwick said, citing his own studies and a recent report by the federal Institute of Medicine. He said changing physicians' practice patterns and hospital financing models will be an important step.

"The best hospital bed is an empty one," he said. "Productivity is the production of health, not the volume of tests."

Threats to health care reform and efforts to reduce costs and improve quality include health care monopolies, the rising number of uninsured Americans, public antipathy and confusion about reform and political battles, he said.

To combat those, Berwick advised five steps: put patients first, protect the disadvantaged, start with small scales, return cost savings to consumers and act locally. Berwick also said educating patients and families to care for themselves and expanding the scope of practice for physician assistants, nurse practitioners and other providers could expand access to care and reduce costs.

Dr. Libby Baxley, senior associate dean for academic affairs at the Brody School of Medicine, echoed Berwick's recommendations for changing the way doctors treat patients and said that would mean changing the way medical students are taught.

"We have to go beyond the traditional education … of the care of the individual and have our students think about populations," she said. "It's really more about being a partner. That's a different set of skills than we've been teaching medical students in the past."

Berwick, a pediatrician, is a founder of the Institute for Health Care Improvement, which aims to reduce errors, waste, delay and unsustainable social and economic costs in health care. He's a graduate of Harvard Medical School. His lecture was sponsored by the Brody School of Medicine, Families USA and the North Carolina Justice Center.

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