Yesterday, Peter Lee, Director of Delivery System Reform in the U.S. Department of Health and Human Services Office of Health Reform, provided the federal government perspective at the National Accountable Care Organization Congress, attended by over 1,100 participants in Century City, CA.  Mr. Lee began with the framework of the “triple aim” of better care, lower costs and better health and underscored that the real challenge is making our health care system a patient- and family-centered one.

He emphasized that what he called the “Medicare shared savings” or accountable care organization activities authorized by the Patient Protection and Affordable Care Act is only one of multiple efforts at payment reform under the PPACA.   He noted the important role of the Center for Medicare and Medicaid Innovation, with a $10 billion budget and the statutory authority to implement any cost savings activities – or cost-neutral but quality improving activities – as soon as there is sufficient evidence to support such reforms.  Mr. Lee also discussed the important contributions to payment reform and quality improvement from the Patient-Centered Outcomes Research Institute (as well as the emerging results from the $1.1 billion already invested in comparative effectiveness research over the past two years),  from patient-centered medical home and advanced primary care projects, and from existing and expanded quality reporting and value based purchasing.  Finally, he noted the important increases in payments and support for primary care and the significantly increased investments in prevention and wellness.

Mr. Lee concluded by setting out the principles for improved health care delivery systems, of which accountable care organizations could be one organizational structure. He highlighted the following key characteristics of the health systems we should be striving for: patient-driven and patient-centered; collaboration among all providers; seamless handoffs and transitions; proactive and anticipatory clinical interventions; proportional investments in patients who need the most support; data-rich and data-driven; use of technologies; and multiple organizational and operational models with common measurements.

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