Turning Collaborative Policy Solutions into Action for Better Health Care
The Brookings Institution is committed to producing innovative policy solutions to our nation’s most difficult challenges. The country may face no more important domestic policy challenge than the much-needed reform of our health care system. To help turn health care reform ideas into action, the Brookings Institution established the Engelberg Center for Health Care Reform.
The Engelberg Center’s mission is to be a catalyst for change by developing data-driven practical health care policy solutions that will foster high-quality innovative care that is both more affordable and more effective at actually improving patient health.
The Center will go beyond merely studying the issues and making policy recommendations. It will promote the broad-based exchange of ideas to develop consensus around practical steps, and then take it one step further by providing technical support for collaborative work among a wide range of health care stakeholders that actually implements the ideas.
The focus is on six key priority areas that are critical to the kind of reform that will improve not just the health care system, but the health of the individual patients. These areas are:
Quality
The U.S. health care system is capable of providing outstanding, innovative care, and it has tremendous potential to lead the world toward further improvements. But the U.S. health care system is by far the world’s most expensive, and it often fails to consistently deliver high-quality, high-value services. The Engelberg Center is emerging as a driving force in a nationwide effort to improve the quality and value through a variety of partnerships and activities designed to find and measure quality health care.
One of the Center’s primary initiatives is to support a broad-based collaboration that aims to provide the public with the information it needs to make decisions about health care, and to provide reliable and meaningful information to support efforts by physicians, nurses, pharmacists, and other health care professionals to improve care. With support from the Robert Wood Johnson Foundation, the collaboration is working with health care providers, consumer advocates, employers and other payers, health plans, and other stakeholders to make sure that broad-based, meaningful information about health care quality and cost is measured reported, and used in a consistent and effective way.
Financing
The U.S. health care system should do a better job of encouraging spending that supports better quality health care. Health insurance benefits should focus more strongly on promoting better health at a lower overall cost. The Engelberg Center is actively engaged in the debate about how to use payments to physicians and other health care providers in ways that help them improve care, building on the contributions and expertise of a wide variety of health care stakeholders and experts. For example, the Center is working with the DartmouthCenterfor Healthcare Policy Research and Reform, using extensive population-based health care data to design new approaches to reform Medicare physician payments to improve quality while reducing the cost of medical care. The Center is also developing evidence on how reforms in health insurance benefits, such as benefits that promote prevention and better coordination of care for chronic diseases, can lead to better quality and lower costs.
Technological Advancement
Almost every industry uses technology in a widespread fashion to improve productivity, quality and lower costs – but health care has lagged behind. The Engelberg Center is moving to change this, supporting collaborative approaches that address the challenges hindering the use of technological tools that help providers improve patient health while lowering overall costs. The goal is not to promote technology for its own sake, but to identify the financial and other barriers to its widespread and efficient use in health care.
For example, the Center will work with a wide variety of groups to help develop business and operating models for increasing the adoption of interoperable health information technology that will assist providers in improving quality and reducing costs. This effort will involve supporting government leadership in key areas where it is needed, such as privacy and security of electronic health information.
Evidence
The work of the Engelberg Center relies on data and evidence to inform analyses of key health policy challenges and developing strategies for addressing them, especially in the area of drug safety.
The Center is at the forefront of efforts to develop better ways of monitoring the safety of drugs after they reach the market. This initiative envisions collaboration across the private and public sector to make it possible to learn more quickly about potential safety problems and the benefits of medical technologies being used in actual practice.
Implementing better ways to use data on safety issues may present new opportunities for learning about how to promote the more effective use of an increasingly diverse and sophisticated range of medical treatments as well. This includes innovative uses of statistical methods and data from actual current medical practice to learn more about the combination of treatments that is best for particular kinds of patients, and how health care policy reforms can promote more effective, personalized care. Through this collaborative effort, the Center aims to provide insights into real-world strategies that achieve better results through more effective use of approved treatments.
Access
In this election year, with voters increasingly concerned about high costs and rising numbers of uninsured Americans, policy makers have a unique opportunity to make substantial progress on improving access to quality health care coverage. The Center is helping these efforts, emphasizing politically and fiscally viable approaches to expanding and improving coverage while avoiding unnecessary medical costs. The Center’s work also includes collaboration with stakeholders on state-specific innovative strategies for reform.
In all these efforts, the Center’s goal is not simply to expand coverage, but to improve quality and reduce preventable and costly health complications.
Innovation
New technologies and scientific breakthroughs, such as genomics, proteomics, better imaging techniques, and nanotechnology, hold tremendous promise for improving patient health through more targeted, prevention-oriented and effective care to patients. However, in many areas, these advances have been making only slow and uncertain progress from the laboratory into standard medical practice.
As the FDA’s Critical Path Initiative and many new scientific methods suggest, there are many opportunities for new collaborations to update and improve the science of safe and effective product development, with the goal of implementing faster and more reliable ways of showing that new innovative treatments are safer and more effective. These reforms in the science of product development could permit more effective ways of regulating medical products and targeting them to patients who are most likely to benefit and avoid side effects – that is, making medical products safer and more effective in their actual use. The Engelberg Center is collaborating with public and private entities to improve the process of bringing new treatments to patients by improving the science of determining the safety and effectiveness of medical products before and after they reach the market. The Center is also collaborating to find better ways to develop and pay for medical treatments that are targeted to particular kinds of patients. These kinds of treatments can be used with more confidence about their benefits and risks.