Ten Cost Cutting Measures In Health Care Reform Bills
by sandy, Fri Nov 13, 2009 at 08:07:37 AM EST
The newest attack on health care reform revolves around the supposed lack of cost cutting measures to curb runaway growth in health care spending despite the President's promise to make cost containment the highest priority in reform.
But the truth is, both the House and Senate bills include a variety of measures that will reduce the growth of health care costs while providing higher quality care. The Senate bill, particularly, includes a tax on high-value "Cadillac" plans which often allow costs to spiral completely out of control. Another proposal creates a commission that would make binding recommendations on wasteful Medicare spending, which has also been endorsed by the Business Roundtable.
Peter Orszag, OMB Director, says that in the discussion on health care reform and cost controls, "too often other important delivery system reforms are ignored" with the result being a failure to recognize that we are "on the verge of passing fiscally responsible health insurance reform". Mr. Orsag further stated that the current health care proposals offer "many promising ideas to improve the overall performance of the U.S. health care system" including ways to "slow long-term spending growth."
Cost containing steps, from the White House, include:
1.Penalties for high readmissions. Too often, patients are discharged from the hospital without the necessary follow-up care leading to re-hospitalization, risks to one's health, and higher costs. Under the proposals being considered, Medicare would collect data on readmission rates by hospital and would assess penalties on those hospitals with high, preventable readmission rates.
2.Bundled payments, which pay a fixed amount for an entire episode of care rather than piecemeal for each individual treatment or procedure, would help improve patient care by encouraging better and more coordinated care than under a fee-for-service system. Bills in both the Senate and the House would develop, test, and evaluate bundled payment methods through a national, voluntary pilot program. Once we see what works and what doesn't, bundled payments can be quickly scaled up across the country.
3. Quality incentives for physicians. Creating incentives in the payment system to reward quality of care rather than just the quantity of procedures. These proposals would expand quality incentives for physicians and provide more timely feedback on physician performance based on their submitted data.
4. Accountable Care Organizations (ACOs). Under the current system, quality and efficiency are not sufficiently rewarded, and there is little incentive for physicians to collaborate in the coordination of patient care. Legislation in both Houses would encourage and reward ACOs, which are groups of providers that are jointly responsible for the quality and cost of health care services for a population of beneficiaries with chronic conditions.
4. Investing in research into what works and what doesn't in health care.
5. Reducing hospital-acquired infections and other avoidable health-center acquired conditions through rigorous reporting and transparency.
6. Putting prevention first, rewarding care that focuses on wellness and treating the whole patient in an integrated and coordinated delivery system.
7. Tackling the insurance bureaucracy, streamlining the payment system to save time and money that is now spent processing claims and navigating through the byzantine insurance system.
8. Establishing a health insurance exchange with a public insurance option, where individuals and small businesses can buy lower-cost insurance that will spur competition and put downward pressure on costs.
In addition, these measures build on the health care reforms that were made in the American Reinvestment and Recovery Act such as beginning the transfer from paper to digital records; strengthening preventive care and patient-centered health research; and investing in the education of primary care providers.