The Center for American Progress (CAP) may be defining the nature and substance of the new administration through the highly visible appointments of senior officials, but it also is offering new templates for policy discussions on issues of the day in ways ordinarily considered nondescript.
But nondescript is not what you will consider The Health Care Delivery System : A Blueprint for Reform, a book co-authored by both CAP and the Institute on Medicine as a Profession.
Outstanding among several policy proposals is the notion of developing a federal commission with the authority to offer one-stop shopping where a would-be integrated organization can obtain a facilitated review of proposals to develop new organizational models and payment approaches.
The authors suggest that the raft of policy pathways offered in the rest of the blueprint are designed to contribute to a larger debate on health system change, and that it aims to ensure that the issues of health care quality and population health are not left out of a debate focused on health care costs and coverage, and that delivery system reform is central to any plan.
The books probes workers, tools and knowledge; the organization of health care delivery; quality of care; provider payment incentives and delivery system reform; second-generation consumerism; and an agenda to improve the health of the public. It argues that the key goals for health system reform must be safety, effectiveness, patient-centeredness, timeliness, efficiency and equity.
To bridge the vision with pragmatic policies, the authors call for infrastructural development, and explain that a health system performing to its potential requires the raw materials necessary for high performance. Policy recommendations include
• investing in federal scholarship and loan repayment programs;
• creating a federal, long-term investment in comparative effectiveness research that will guide clinical practice and payment systems;
• providing federal funds to support the acquisition of federally certified electronic health records (EHR), their maintainance; and
• the technical assistance needed to implement and use the EHRs effectively.
The book also calls for increased organization to confront the chaos in everyday health care.
“We should focus our efforts on accelerating the organization of health care providers into team-like configurations so that they can adopt systems that are likely to reduce errors of overuse, underuse, and misuse, and improve the overall co-ordination of care,” it says.
They say: “The signs that such a debate could take place in the near future are strong. Both presidential candidates proposed to reform the health care system, demonstrating the political ripeness of the issue. When that opportunity presents itself, it will be essential to be ready with grounded policies that are more than patches, and can serve as pathways toward a high-performing health system.”