Helping concerned consumers find low cost health insurance for their families and businesses.
Monday, April 29, 2013
Friday, April 19, 2013
Thursday, April 18, 2013
Diverse Groups Forge Consensus on Curbing Health Care Spending While Improving Quality
Unlikely partnership releases five integrated recommendations to improve health care.
- Published: 4/11/2013
Calling itself the Partnership for Sustainable Health Care, the group
includes nationally prominent advocates for employers, insurers, consumers,
health care providers and others. Participants include America’s Health
Insurance Plans, Ascension Health, Families USA, National Coalition on Health
Care and Pacific Business Group on Health.
“No single organization working alone, and no single policy approach, will achieve the lower-cost, higher-quality imperative. Moderating health costs while improving quality of care must be an all-hands-on-deck commitment,” said Ron Pollack, executive director of Families USA. “It is high time for us to bend the cost curve and improve patient care by fully engaging the public and private sectors, rather than perpetuating cost shifts among sectors or to consumers.”
The organizations recommend a set of integrated, system-wide approaches involving both the public and private sector that they say will significantly curb the growth in health care spending and enhance the delivery of care. The organizations met regularly for more than a year to develop proposals and were supported in their work with a grant from the Robert Wood Johnson Foundation.
“We believe our health system will generate better value when consumers and providers face aligned incentives—based on evidence of what works—that reward quality care and efficient use of resources,” said David Lansky, president and CEO of the Pacific Business Group on Health. “Our work together shows that representatives of diverse interests can work in the public interest toward a common approach to improving health care.”
The group’s recommendations are five-fold:
Leaders of the Partnership believe their comprehensive approach to integrate public and private sector actions toward improving the health system will help stop the ‘silo effects’ of health care, including shifting costs from one partner or sector to another.
“High-value, affordable health care for individuals and families requires a sustained commitment by all stakeholders to actively engage and address the drivers of health costs throughout the system,” said Karen Ignagni, president and CEO of America’s Health Insurance Plans. “Today's report presents an actionable roadmap for reform.”
The leaders say they understand that change will not happen easily or quickly, but believe these recommendations create the opportunity for significant momentum in the immediate future, for system-wide transformation, toward which substantial progress can be achieved in just five years.
“To meet America’s health care needs, with special attention to the poor and vulnerable, we know that health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Moving to managing the health of defined populations demands recognition and acceptance of the magnitude of the transformational change required,” said Robert Henkel, FACHE, president and CEO of Ascension Health. “The consensus recommendations we present today provide a roadmap to move our country toward an achievable, high-performing, person-centered, coordinated system with lower costs.”
The Partnership organizations plan to continue their work by reaching out to and engaging many other health care stakeholder groups that are also interested in promoting health cost efficiencies while improving quality of care.
See the Partnership for Sustainable Health Care recommendations at www.rwjf.org.
Media Contact:
Alexis Levy | Robert Wood Johnson Foundation | media@rwjf.org | (609) 627-5702
“No single organization working alone, and no single policy approach, will achieve the lower-cost, higher-quality imperative. Moderating health costs while improving quality of care must be an all-hands-on-deck commitment,” said Ron Pollack, executive director of Families USA. “It is high time for us to bend the cost curve and improve patient care by fully engaging the public and private sectors, rather than perpetuating cost shifts among sectors or to consumers.”
The organizations recommend a set of integrated, system-wide approaches involving both the public and private sector that they say will significantly curb the growth in health care spending and enhance the delivery of care. The organizations met regularly for more than a year to develop proposals and were supported in their work with a grant from the Robert Wood Johnson Foundation.
“We believe our health system will generate better value when consumers and providers face aligned incentives—based on evidence of what works—that reward quality care and efficient use of resources,” said David Lansky, president and CEO of the Pacific Business Group on Health. “Our work together shows that representatives of diverse interests can work in the public interest toward a common approach to improving health care.”
The group’s recommendations are five-fold:
- Transform the way health care providers are paid, to emphasize value of services provided, rather than volume. Partnership members believe that private and public insurance programs must transition from the current ‘fee-for-service’ payment system to one that better rewards quality and value. They call on the public and private sectors to implement a range of alternative payment and delivery models over the next five years, in order to quantify results and spread successful models.
- Pay for care that is proven to work. Partnership members recommend a tiered reimbursement strategy that links payment directly to effectiveness. They recommend that both public and private insurers reduce payment for services that prove to be less effective and to have weaker value than alternative therapies.
- Encourage consumers to choose high-quality care. Partnership members recommend incentivizing consumers to select high-performing providers. They point to models like value-based insurance design, which offer financial incentives to consumers—such as reduced cost-sharing—when they opt for evidence-based treatments and obtain care from providers who deliver high-quality care. Traditional Medicare should be modified to allow tiered cost-sharing for beneficiaries who use high-quality providers, and drugs and services that are proven effective.
- Improve the nation’s health care infrastructure. Partnership members recommend reforms aimed at strengthening the foundational infrastructure of America’s health care system so that cost- and quality-related innovations can be implemented more effectively. They call for establishing a uniform and prudent set of quality and other performance measures to be used by both the public and private sectors to support provider payment reform, consumer incentives and healthy competition in health care markets.
- Incentivize states to improve care. Partnership members recommend establishing a gain-sharing program for states, which would encourage innovative approaches to controlling health care costs. States that participate would outline specific savings goals, with defined rewards for meeting them. States that slow the growth of total spending would be rewarded with a percentage of the savings. The recommendations include numerous ways to ensure that cost-reduction is accomplished responsibly and builds upon the access gains achieved through the Affordable Care Act.
Leaders of the Partnership believe their comprehensive approach to integrate public and private sector actions toward improving the health system will help stop the ‘silo effects’ of health care, including shifting costs from one partner or sector to another.
“High-value, affordable health care for individuals and families requires a sustained commitment by all stakeholders to actively engage and address the drivers of health costs throughout the system,” said Karen Ignagni, president and CEO of America’s Health Insurance Plans. “Today's report presents an actionable roadmap for reform.”
The leaders say they understand that change will not happen easily or quickly, but believe these recommendations create the opportunity for significant momentum in the immediate future, for system-wide transformation, toward which substantial progress can be achieved in just five years.
“To meet America’s health care needs, with special attention to the poor and vulnerable, we know that health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Moving to managing the health of defined populations demands recognition and acceptance of the magnitude of the transformational change required,” said Robert Henkel, FACHE, president and CEO of Ascension Health. “The consensus recommendations we present today provide a roadmap to move our country toward an achievable, high-performing, person-centered, coordinated system with lower costs.”
The Partnership organizations plan to continue their work by reaching out to and engaging many other health care stakeholder groups that are also interested in promoting health cost efficiencies while improving quality of care.
See the Partnership for Sustainable Health Care recommendations at www.rwjf.org.
Media Contact:
Alexis Levy | Robert Wood Johnson Foundation | media@rwjf.org | (609) 627-5702
About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.Monday, April 1, 2013
Joel Hay: We can't afford Affordable Care Act
The Orange County Register
Published: March 29, 2013 Update
Obamacare's biggest selling point is that beginning next year all Americans
will have a path to health care coverage. In fact, as Chief Justice Roberts
upheld in a 5-4 vote at the Supreme Court last summer, after 2013, it will be
illegal for any of us not to carry health insurance. Obamacare's biggest flaw is
how expensive and wasteful it will be in accomplishing this expanded health care
access.
The Affordable Care Act will add about 27 million Americans to the insured
population and will likely increase government health care spending by more than
$2.5 trillion over the next decade. Even the Congressional Budget Office
estimates the 10-year Obamacare costs at $1.9 trillion through 2023, and this
doesn't include any of the $300 billion annual health insurance premium tax
exemptions that are crucial to ensuring that most private employers don't push
all of their workers into the Obamacare Health Insurance Exchanges in 2014. It
also doesn't include the $716 billion that was taken out of Medicare to help
fund Obamacare without raising federal deficits.
This means that each newly added Obamacare beneficiary will cost the federal
government about $100,000 to insure over the next 10 years. Only in Washington,
D.C. could this even begin to sound logical or financially responsible. I'll bet
that at least 95 percent of those who will get Obamacare coverage would rather
just take the $100,000 than the Medicaid or Health Insurance Exchange health
plans that federal and state bureaucrats are busily designing for them. For
$100k, they'd gladly take their chances with the free care already provided by
USC medical professors and residents at L.A. County Medical Center or other
similar existing facilities.
Obamacare does nothing to deal with the 800-lb. health care gorilla –
government programs cost too much. Medicare already has a $60 trillion unfunded
liability for promises to future retirees. Just the spending for Obamacare,
Medicaid and Medicare will raise deficits for the next 60 years to a level that
will absorb over 20 percent of the entire economy, as much as the federal
government spends on all its programs today. Actually, Obamacare does pay lip
service to cost containment with a whole slew of new gobbledy-speak acronyms
like ACOs (Accountable Care Organizations), PCMHs (Patient-Centered Medical
Homes), EHRs (Electronic Health Records) and PCORI (Patient-Centered Outcomes
Research Institute).
The problem is, while adding substantial administrative overhead costs, there
is no evidence that any of these new bureaucratic contraptions will save any
money.
The Obama stimulus spending pumped $30 billion into expanding electronic
health records over the past four years and the consensus is that this has
increased health care costs, not reduced them. As Stephen Soumerai from Harvard
Medical School and Ross Koppel from the University of Pennsylvania wrote, "...
The most rigorous studies to date contradict the widely broadcast claims that
the national investment in health IT – some $1 trillion will be spent, by our
estimate – will pay off in reducing medical costs."
All of the Patient-Centered Medical Home demonstrations done thus far have
found that they significantly increase health care costs. Accountable Care
Organizations, which are supposed to give physicians financial incentives to
manage their patients better, have no mechanism to keep patients returning to
them for care, and are thus as loophole-free as Swiss cheese. Even ACO
proponents claim that in ideal circumstances ACOs will only slow the rate of
growth of health care spending, not actually reduce it. And PCORI? PCORI is now
spending billions of dollars to analyze health care services. This money is
provided by a new Obamacare head tax on every health plan beneficiary. But there
is a slight catch. Under Obamacare, it is illegal for PCORI to actually evaluate
medical costs.
It could all have been done so much more simply by guaranteeing every
American a catastrophic coverage health insurance plan that kicks in once their
existing health benefit costs or annual out-of-pocket medical expenditures
exceeded 15 percent of family income. By using existing health insurance premium
tax expenditure loopholes to pay for it, taxes increases would have been
unnecessary.
The Congressional Budget Office projects that at least 30 million people will
still be uninsured in 2022, more than the 27 million that Obamacare adds to the
covered roles.
But by then Democrats will be looking to pass Obamacare Part Deux, which will
almost surely be single-payer health care for all. And when health care is free,
you'll get what you pay for.
Joel W. Hay is a professor at the USC
Schaeffer Center for Health Policy and Economics.
Subscribe to:
Posts (Atom)