U.S. Department of Health and Human Services Secretary Mike Leavitt discussed how to build a value-driven healthcare system at an Aug. 1 town hall meeting organized by the North Carolina Healthcare Information and Communications Alliance (NCHICA) and the WNC Health Network in Asheville, N.C.
Leavitt noted that healthcare spending is currently 16.7 percent of the gross domestic product, and is projected to be as high as 30 percent by the time his grandson has a child. It is “an economic imperative that we deal with this,” Leavitt said.
According to Leavitt, Medicare is at the heart of the problem, since other insurance companies pattern themselves after Medicare's system of billing. The agency currently pays for everything separately, pays the same for high quality and low quality care and offers incentives based on volume, not value.
Under the secretary's plan, there are four cornerstones of value-driven healthcare: health IT standards, quality standards, price standards and incentives.
"We don't have a healthcare system, but a healthcare sector," said Leavitt. His solution is to form chartered value exchanges (CVE), community-based collaboratives that include providers, employers, health plans and consumers. "We need national standards but local control," which will be provided by the CVEs.
Leavitt said that there are currently 14 CVEs across the country, and he would like to have 25 by January 2009. He asked the healthcare leaders in the audience to consider forming a CVE in North Carolina.
Following the meeting with Leavitt, the NCHICA board of directors passed a resolution to lead the effort to establish a CVE in North Carolina. Last year, the NCHICA was designated a community leader for value-driven healthcare by Leavitt, one of the requirements to be a CVE.
"The NCHICA board of directors fully supports the secretary's value-driven healthcare initiative, and we look forward to working with other healthcare stakeholders in the state to form a chartered value exchange," said Bill Mattern, MD, chair of the NCHICA board.