Dr. Don Berwick has been named Medicare and Medicaid administrator. His views on “The Triple Aim“: Care, Health and Cost” provide a blueprint for change. Whether we are able to adopt some of these aims is a big question”
If we could ever find the political nerve, we strongly suspect that financing and competitive dynamics such as the following, purveyed by governments and payers, would accelerate interest in the Triple Aim and progress toward it:
(1) global budget caps on total health care spending for designated populations
(2) measurement of and fixed accountability for the health status and health needs of designated populations,
(3) improved standardized measures of care and per capita costs across sites and through time that are transparent,
(4) changes in payment such that the financial gains from reduction of per capita costs are shared among those who pay for care and those who can and should invest in further improvements, and
(5) changes in professional education accreditation to ensure that clinicians are capable of changing and improving their processes of care.
Medicynical Note: I like the idea of global budgets. We need to change the money driven attitudes of our non-system and balance it with reality, quality and the notion of performing a service.
People always have the option of funding, themselves, that which is not able to be covered or which is deemed not good enough for coverage by the general program.