Pre-State of the Union Reflections

President Obama’s upcoming State of the Union speech will be met with high expectations. Not only is this his first chance to address Congress since the November election, but it comes on the heels of eloquent remarks about the importance of civil public discourse following the Arizona shootings that drew praise from both sides of the aisle.

The President’s speech will give us some clues about how the rest of his term could go, particularly as it relates to Congressional relations. This is most important in the arena of health care reform. The House just this week passed a bill repealing the Affordable Care Act, but this measure will likely fail in the Senate. There is no doubt that the public is divided about whether the new health care reform law is the right approach for improving care, increasing coverage and reducing costs.

The next few months are expected to usher in a period of continued debate about changing federal health reform legislation. The State of the Union speech should tell us what President Obama hopes to achieve.

I hope the President will mention progress on the much-anticipated rules for accountable care organizations (ACOs) being written by the Centers for Medicare and Medicaid Services. The broad outlines for how ACOs will operate are becoming clearer, but many of the details are yet to be ironed out. ACOs could have a profound impact on how Americans access quality care in the future: This system would provide a financial incentive for reliable performance measurement and improved outcomes.

I hope the President also will recognize that profound change is sweeping through health care independent of the ongoing Washington debate: industry consolidation, greater partnerships between hospitals, physicians and other health professionals, and an increased emphasis on shared responsibility for improving health outcomes and reducing costs. I recently spoke with UNC-TV’s NC Now about these changes.

Regardless of what happens at the federal level, it seems clear that health care delivery models based on patient volume alone is not sustainable. UNC Health Care is moving swiftly to put in place new arrangements that make possible more cooperation and between primary care, in-patient care and specialty providers.

One way UNC Health Care is working to keep pace with these changes is our innovative, first-of-its-kind partnership with Blue Cross and Blue Shield of North Carolina to form a new medical practice based on the medical home approach. We also are partnering more closely with physician groups, bringing them greater IT resources for decision making and integrating their expertise into our hospital system.

The oft-stated goals of health care reform promoted by the president and the opponents of his approach to reform are similar to the mission of UNC Health Care – improving quality and efficiency so that we can ensure patients have access to excellent and affordable care. I look forward to hearing what President Obama sees as the next steps to reaching this goal.

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