Strengthening primary care and adjusting reimbursement to cover high-value care of complex patients could cut $2 trillion from health care costs in the next 10 years, according to policy analysts.
The Commonwealth Fund published its findings in a white paper.
The savings would total $1 trillion for the federal government, $537 billion for households, $242 billion for state and local government and $189 billion for employers.
For the federal government, net savings would easily offset the 10-year costs of the sustainable growth rate (SGR) formula, the white paper stated. The "major winners" would be households, which would have lower insurance premiums and out-of-pocket costs, the report said.
The 10 steps are:
--Revise Medicare physician fees and methods of updating payment to pay for value;
--Strengthen primary care and support care teams for high-cost, complex patients;
--Bundle hospital payments to focus on total costs and patient outcomes;
--Adopt payment reforms across public and private payers;
--Offer Medicare beneficiaries a new "Medicare Essential" plan that provides more comprehensive benefits and better protection against catastrophic costs and includes provider and enrollee incentives to achieve better care, better health, and lower costs;
--Provide incentives for Medicare and Medicaid beneficiaries to seek care from high-value, patient-centered medical homes and other systems;
--Enhance information on clinical outcomes of care and patient experiences to inform treatment decisions and choices of providers and care systems;
--Simplify and unify administrative policies and procedures across public and private health plans;
--Reform medical malpractice policy and link to payment in order to provide fair compensation for injury while promoting patient safety and adoption of best practices; and
--Establish spending targets.
"U.S. health spending has been growing far faster than wages and putting stress on families and businesses as well as federal and state budgets," said Commonwealth Fund president and Commission chair David Blumenthal, MD, MPP, FACP. "We know that by innovating and coordinating care, our health care system can provide better care at lower costs. The Commission report lays out a framework and set of strategies to accelerate innovation, with the potential to substantially lower federal costs while protecting Medicare and Medicaid beneficiaries."