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Tackling Health Care Costs: Finding Common Ground

Friday, December 13, 2013

Despite slower health care spending growth over the last few years, long-term forecasts for overall health spending – and for public programs like Medicare – signal continuing concern.

The idea behind numerous recent proposals is to find lasting solutions, and some areas of consensus are beginning to emerge.

Many proposals recommend paying for value instead of volume through such delivery models as patient-centered medical homes and accountable care organizations. Some encourage improvements in market competition, by instituting competitive bidding and increasing the availability of information. There is also some agreement on establishing spending targets.

Which proposals can garner support from various policymakers and stakeholders? How much money would these proposals save and what would be their effect on quality of care? What would it take to get the ball rolling on consensus proposals, and what are the challenges to widespread adoption?

Paul Ginsburg, president, Center for Studying Health System Change, identified cost containment proposals that are gaining broad support.

Len Nichols, director, Center for Health Policy Research and Ethics, George Mason University, assessed the cost-curbing potential of initiatives underway in both private and public sectors, including those in the Affordable Care Act.

Sheila Burke, adjunct lecturer in public policy, Harvard Kennedy School of Government, offered insights into the acceptability, across the political and stakeholder spectrum, of major components of various proposals.

Marilyn Serafini of the Alliance and Rachel Nuzum of Commonwealth co-moderated.

Contact: Marilyn Serafini (202)789-2300

Follow the briefing on Twitter: #CostConsensus

The event was sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.

Health Care Cost-Containment Proposals

Key Points

While proposals span different stakeholders and political ideologies, said Paul Ginsburg, they consistently called for the diminished role of fee-for-service models and the increased use of other payment approaches to promote coordination of care and improve patient outcomes.

The policy community should help providers already using alternative payment models and those trying or willing to make the transition, Len Nichols stated. He also noted that both government and private payers should give providers incentives to meet global targets.

Sheila Burke emphasized that in order to reform payment incentives and programs, proposals recommend linking payment to performance and focusing more on quality.

Giving greater authority to states to innovate will improve Medicaid, Ginsburg stated.

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Full Transcript (Adobe Acrobat PDF), 12/13/2013
Full Webcast/Podcast: Full Video from C-SPAN

Speaker Presentations

Ginsburg Presentation (Adobe Acrobat PDF), 12/13/2013
Nuzum Presentation (Adobe Acrobat PDF), 12/13/2013

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), , 12/13/2013
Materials List (Adobe Acrobat PDF), , 12/13/2013
Source List (Adobe Acrobat PDF), , 12/13/2013
Speaker Biographies (Adobe Acrobat PDF), , 12/13/2013

Offsite Materials (briefing documents saved on other websites)

Links to Nine Major Cost Containment Proposals (Adobe Acrobat PDF),, 12/12/2013
Finding Consensus on Policies to Slow Health Spending Growth, The Commonwealth Fund, 9/26/2013
Health Care Costs, Alliance for Health Reform; Robert Wood Johnson Foundation, 10/1/2013
Spending Growth in September Continues Course to Record Low (Adobe Acrobat PDF),Altarum Institute, 11/13/2013
US Health Spending Growth Projected to Average 5.8 Percent Annually Through 2022, Health Affairs Blog, 9/18/2013
Seven Challenges for Continued Health Care Cost Control: Will Congress Step Up to the Plate?, Altarum Institute, 8/20/2013
How to Build a Better Health-Care System, The Washington Post, 4/18/2013
Achieving Health Care Cost Containment Through Provider Payment Reform That Engages Patients and Providers, Health Affairs, 5/1/2013
Patient Engagement Is The Key, Health Affairs Blog, 8/8/2013
Doctors Tepid About Cost Containment, Healthcare Finance News, 8/8/2013
Preserving Medicare for Future Generations: Market-Based Approaches to Reform, American Enterprise Institute; Robert Wood Johnson Foundation, 4/12/2013
Grants Help State Combat High-Cost, Low-Quality Health Care, Stateline, 11/18/2013
Per Capita Caps In Medicaid, Health Affairs, 4/18/2013
Lowering Prescription Drug Costs (Adobe Acrobat PDF),National Coalition on Health Care, 7/1/2013
Reducing the Cost of Defensive Medicine, Center for American Progress, 6/11/2013
Plan Competition and Consumer Choice in Medicare: The Case for Premium Support, American Enterprise Institute; Robert Wood Johnson Foundation, 4/15/2013
A Competitive Bidding Approach to Medicare Reform, American Enterprise Institute; Robert Wood Johnson Foundation, 4/16/2013
Comparing Health Care Cost Containment Proposals Matrix (Adobe Acrobat PDF),The Commonwealth Fund, 10/1/2013
Testimony on Containing Health Care Costs: Recent Progress and Remaining Challenges before the Senate Budget Committee, Senate Budget Committee, 7/30/2013
Addressing Rising Health Care Costs. A Resource Guide for Consumer Advocates (Adobe Acrobat PDF),Consumers Union; Robert Wood Johnson Foundation, 11/10/2013
New Models to Pay for Health Care (Adobe Acrobat PDF),Academy Health, 8/1/2013


Len Nichols

The SGR should not be fixed in isolation, but as part of a broad reform, Paul Ginsburg, president, Center for Studying Health System Change, stated at a December 13 Alliance briefing, Tackling Health Care Costs: Finding Common Ground.

Sheila Burke


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