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December 2015 (Volume 93)
Donald M. Berwick
From their inception, Medicare and Medicaid have been shaped and guided by health services research (HSR) and its people. The linkages are numerous: ideas (like Diagnostic Related Groups, or DRGs, Resource-Based Relative Value Scale, or RBRVS, and Accountable Care Organizations, or ACOs), tools (like those from the RAND Health Insurance Experiment, the Medical Outcome Study, and the HCAHPS family), frameworks, and, of course, people who oscillated between academia and government, to the benefit of both.
As administrator of the Centers for Medicare and Medicaid Services (CMS) from 2010 to 2011, I saw productive contributions of HSR to CMS policy, regulation, and operations every day. That is a track record to be proud of. But there are gaps, some big ones, and a rechartered agenda for HSR could help boost American health care to its next and needed levels of performance.
The following are 10 suggested topics for HSR to focus on in the next decade, more understanding of which would help health care leaders, including CMS, to move more rapidly toward better care for individuals, better health for populations, and lower per capita cost through improvement: the “Triple Aim.”1,2
Overall, HSR can take a deep bow for its assistance to the world of Medicare and Medicaid policy, regulation, and operation. But to be even more helpful, its future agenda should invest in the yet unmet needs for knowledge. Especially at a time of such conflict and confusion in health care policy, HSR has both the burden and the privilege to lead on new paths to better care, better health, and lower costs.
Author(s): Donald M. Berwick
Read on Wiley Online Library
Volume 93, Issue 4 (pages 659–662)
Published in 2015
Donald M. Berwick, MD, MPP, FRCP, is president emeritus and senior fellow at the Institute for Healthcare Improvement, an organization that Berwick cofounded and led as president and CEO for 18 years. In July 2010, President Obama appointed Berwick to the position of administrator of the Centers for Medicare and Medicaid Services, which he held until December 2011. A pediatrician by background, Berwick has served as clinical professor of pediatrics and health care policy at the Harvard Medical School and professor of health policy and management at the Harvard School of Public Health. He is an elected member of the National Academy of Medicine. Berwick is the author or coauthor of over 160 scientific articles and 6 books. He is now a lecturer in the Department of Health Care Policy at Harvard Medical School.
Health Care Reform and the American Congress