Posted: 12:11 p.m. Thursday, April 11, 2013
By Julie Appleby
Five veteran health care leaders representing insurers, hospitals, employers and consumers on Thursday outlined an ambitious set of recommendations aimed at slowing rising costs, focused mainly on changing the way America pays for health care.
Many of the ideas draw on existing efforts, such as accelerating Medicare’s efforts to pay for quality rather than just quantity of care. Working together as the Partnership for Sustainable Health Care, they also recommend greater incentives to promote quality, such as reimbursing providers more for treatments shown to be most effective — and reimbursing them less for those with more uncertain benefits.
One proposal would offer financial carrots to states: Voluntarily find ways to slow rising health care costs without cutting coverage or services — and share in any savings gleaned by Medicare, Medicaid and other government programs.
“There is broad agreement on the elements needed for change,” said David Lansky, president and CEO of the Pacific Business Group on Health, a coalition of employers.
His group is one of the five partnership members, which also includes America’s Health Insurance Plans, a trade lobby for the insurance industry, hospital firm Ascension Health, the National Coalition on Health Care, a nonprofit research group, and Families USA, a consumer advocacy group.
If they are to work, the proposals would require changes in the private sector, as well as national and state legislation. Congress would have to act, for example, on any proposal aimed at sharing federal savings with states that come up with ways to trim health costs.
“We’re not just singing Kumbaya … this is a real, specific, integrated approach,” said Ron Pollack, executive director of Families USA.
“We wanted to avoid the same old, inside-the-beltway approach,” which has often simply meant shifting costs onto consumers or from one program or industry to another, Pollack said.
But that means getting others on board — a potentially challenging effort because it would change the way doctors and hospitals are paid. Consumers, too, would see changes, including having some of their reimbursements tied to their choices about treatments or providers, based on their relative cost and quality.
Some private insurance plans are already moving in that direction, but have a long way to go. A recent report by an employer group, for instance, found than only 11 percent of spending by employers on health care last year was tied to the value of the care provided.
Former AARP lobbyist John Rother, now president and CEO of the National Coalition on Health Care, said he thinks the effort won’t be as politically tough as expanding coverage to the uninsured or passing the Affordable Care Act.
“We’re focused on health care delivery, which is not as polarized,” said Rother.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.