Speeding up delivery system transformation could trim upward of $2 trillion in health care spending between 2014 and 2023, according to a plan issued last month by the Commonwealth Fund Commission on a High Performance Health System. So, how would the commission get there? An ambitious 10-point plan:
Payment reforms to accelerate delivery system innovation.
[ Savings: $1.33 trillion ]
- Pay for value: replace physician fee schedule with payment incentives to improve care.
- Strengthen patient-centered primary care and support care teams.
- Bundle hospital payments to focus on total cost and outcomes.
- Align payment incentives across public and private payers.
Expand and encourage high-value choices by consumers.
[ Savings: $189 billion ]
- Offer Medicare beneficiaries a "Medicare Essential" plan that provides more comprehensive benefits and better protection against catastrophic costs; include 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, care teams, ACOs and integrated delivery systems.
- Use health IT and other means to provide more information on clinical outcomes.
Systemwide actions to improve how health markets function.
[ Savings: $481 billion ]
- Simplify and unify administrative policies and procedures.
- Reform malpractice policies.
- Establish a spending target across all payers, which should not exceed per capita economic growth.
