Old science, new tools.

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Up Next for Obamacare: Transforming Medicine

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When President Barack Obama signed the Affordable Care Act, six years ago this week, he addressed the rancor the health-care debate had inspired with a call to resist cynicism. “We are not a nation that does what’s easy," he said. "We are a nation that does what is hard. What is necessary. What is right. Here, in this country, we shape our own destiny.”

It hasn’t been easy, and there have been challenges along the way, but we have made significant progress. Today, 20 million people have gained coverage because of the health law. Health-care prices have risen at the slowest rate in five decades. And with new protections and benefits, everyone’s insurance is higher quality, no matter where it’s purchased.

Today, thanks to the law, families across the country can get preventive care at no extra cost. They no longer have to worry about annual or lifetime caps on coverage. And they no longer have to worry about being denied insurance because they survived cancer or live with a chronic condition.

Obamacare, Assessed

These gains are historic, but health-care reform has always been about more than insurance. It’s also about building a health care system that puts patients in the center and works better for all Americans. 

We have some of the best doctors in the world, but with high costs, uncoordinated care and a complex and confusing system, many Americans, both insured and uninsured, have been unsatisfied with their health-care experience.

Fortunately, the health-care law gave us new tools to improve how we deliver care and encourage innovation.

Imagine your sister needs knee surgery. From the emergency room to surgery, to recovery and a physical therapist, she meets with dozens of doctors, nurses and specialists. Right now, most insurance pays for each test, treatment or procedure separately. So everyone is focused solely on their role, not on working together. Without communication, they might order the same X-ray or blood test twice, and your sister may have to pay. And they might not have the time to sit down and make sure she understands how to avoid reinjuring her knee.

This kind of care doesn’t prioritize quality, leaving us with higher costs. Thanks to the health law, we’re moving to a system that thinks of care in terms of how good, not how much.

If your sister were a patient in certain medical practices today, her doctors would work as a team. Her ER doctors would electronically share her X-rays with orthopedic specialists. Her family physician would tell her physical therapist about her asthma. Her nurses would take the time to make sure she understands her treatments. And a care coordinator would remind her about her follow-up care. 

The federal government is working to make this patient-centered care the norm, not the exception. We’re getting there in three ways.

First, we are changing how we pay doctors, so they can focus on the quality of care they provide, not the quantity of services they order. The health law created the Center for Medicare and Medicaid Innovation, focusing on alternative payment models that do just that. For instance, we announced a new payment model last year that creates one payment for a hip or joint replacement and recovery, rather than dozens of payments for each individual service.

The administration recently met its goal to tie 30 percent of Medicare payments to these kinds of models, and we’re also working to find smarter ways to pay for drugs.

Next, we are improving care, by encouraging better coordination and prioritizing wellness and prevention. If we can avoid illnesses before they happen, we can improve lives and save money. By encouraging best practices and reducing the injuries and infections patients acquire at hospitals, we have saved an estimated 87,000 lives and nearly $20 billion in cost savings.  

Finally, we are unlocking health-care data. With information that can move where it’s needed, we can give doctors what they need to provide the best possible care and empower patients. We’re working with some of the biggest, most influential names in health care, including the Hospital Corporation of America, the American Medical Association and Epic Systems Corp., to increase consumer access and implement shared standards to put health data to work. 

This kind of system means better care, where doctors work together and have a full understanding of patients’ needs. It’s smarter, where we pay for what works and spend our money more wisely. And it’s healthier, with engaged and empowered patients who lift up the health of our whole country.

Progress isn’t easy, but what we have accomplished in six short years is undeniable: 20 million now covered, billions of dollars saved and changes that are making our system work better for everyone. We are beginning to transform our health care system in ways that are changing people’s lives for the better, and the health law that has put us on this path. 

And this is hardly the end. We will continue to use tools created by the law to build a better, smarter, healthier system -- a system that puts people at its center. Not because it is easy, but because it is necessary and because it is right.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Sylvia Mathews Burwell at sylvia.burwell@hhs.gov

To contact the editor responsible for this story:
Christopher Flavelle at cflavelle@bloomberg.net