Analysis & commentary achieving health care cost containment through provider payment reform that engages patients and providers

Health Affairs

Volumn 32, Issue 5, 2013, Pages 929-934

  Ginsburg, Paul B ^a  

^a CENTER FOR STUDYING HEALTH SYSTEM CHANGE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST CONTROL; HEALTH CARE COST; HEALTH CARE ORGANIZATION; HEALTH CARE POLICY; HEALTH PROGRAM; HEALTH SERVICE; MEDICAID; MEDICAL FEE; MEDICARE; PROSPECTIVE PAYMENT; REIMBURSEMENT; ACCOUNTABLE CARE ORGANIZATION; CARE BUNDLE; ECONOMIC MODEL; ECONOMICS; HUMAN; ORGANIZATION AND MANAGEMENT; PILOT STUDY; PROCEDURES; UNITED STATES; BUSINESS OF HEALTH; COST OF HEALTH CARE; HEALTH ECONOMICS; HEALTH SPENDING; METHODOLOGY; STATISTICAL MODEL;

ACCOUNTABLE CARE ORGANIZATIONS; COST CONTROL; FEE-FOR-SERVICE PLANS; HEALTH CARE REFORM; HUMANS; MEDICAID; MEDICARE; MODELS, ECONOMIC; PATIENT CARE BUNDLES; PILOT PROJECTS; REIMBURSEMENT MECHANISMS; REIMBURSEMENT, INCENTIVE; UNITED STATES;

BUSINESS OF HEALTH; COST OF HEALTH CARE; HEALTH ECONOMICS; HEALTH SPENDING; PHYSICIAN PAYMENT;

EID: 84877993595     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.1007     Document Type: Article

References (17)

1. Congressional Budget Office. The 2012 long-term budget outlook [Internet]. Washington (DC): CBO; 2012 Jun 5 [cited 2013 Mar 25]. Available from: http://cbo.gov/publication/43288
2. See the recent studies by the Center for Studying Health System Change, available at California HealthCare Foundation. California health care almanac: regional markets [Internet]. Sacramento (CA): The Foundation; [cited 2013 Mar 29]. Available for download from: http://www.chcf.org/almanac/regional-markets
3. Shedden M. Area leaders frustrated by Baycare, UnitedHealthcare dispute. TBO: The Tampa Tribune [serial on the Internet]. 2012 Dec 7 [cited 2013 Mar 29]. Available from: http://www2.tbo.com/lifestyles/health-4-you/2012/dec/07/2/arealeaders-frustrated-by-baycareunitedhealthcar-ar-580013/
4. Cosgrove DM, Fisher M, Gabow P, Gottlieb G, Halvorson GC, James BC, et al. Ten strategies to lower costs, improve quality, and engage patients: the view from leading health system CEOs. Health Aff (Millwood). 2013;32(2):321-7.
5. Song Z, Safran DG, Landon BE, Landrum MB, He Y, Mechanic RE, et al. The "Alternative Quality Contract," based on a global budget, lowered medical spending and improved quality. Health Aff (Millwood). 2012;31(8):1885-94.
6. Governor's Health Care Reform Task Force. Total cost of care contracting in Minnesota: current activity [Internet]. St. Paul (MN): Health Reform Minnesota; 2012 Apr 2 [cited 2013 Feb 25]. Available from: http://mn.gov/health-reform/images/Task-Force-2012-04-02-Total-Cost-of-Care-Contracting%20in%20MN.pdf
7. Hartman M, Martin AB, Benson J, Catlin A, the National Health Expenditure Accounts Team. National health spending in 2011: overall growth remains low, but some payers and services show signs of acceleration. Health Aff (Millwood). 2013;32(1):87-99. Exhibit 3, National Health Expenditures (NHE), amounts and average annual growth from previous year shown, by source of funds, selected calendar years 1990-2011.
8. Center for Medicare and Medicaid Innovation. Comprehensive Primary Care initiative [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; [cited 2013 Feb 25]. Available from: http://www.innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Initiative/
9. Department of Health and Human Services [Internet]. Washington (DC): HHS. News release, More doctors, hospitals partner to coordinate care for people with Medicare: providers form 106 new accountable care organizations; [last revised 2013 Jan 14; cited 2013 Mar 29]. Available from: http://www.hhs.gov/news/press/2013pres/01/20130110a.html
10. CMS.gov. Bundled Payments for Care Improvement (BPCI) Initiative: general information [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; 2013 Jan 31 [cited 2013 Apr 17]. Available from: http://innovation.cms.gov/initiatives/bundledpayments/
11. This issue does not apply to the Comprehensive Primary Care initiative, which continues to make feefor-service payments to primary care physicians but adds a uniform capitated amount for coordination services.
12. Such an approach was outlined in Bipartisan Policy Center. A bipartisan Rx for patient-centered care and system-wide cost containment [Internet]. Washington (DC): The Center; 2013 Apr [cited 2013 Apr 18]. Available from: http://bipartisanpolicy.org/library/report/health-care-cost-containment. Legislation along these lines was recently reintroduced by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV) (Medicare Physician Payment Innovation Act of 2012, H.R. 5707).
13. This approach would be similar to the transition to the Medicare Inpatient Prospective Payment System in the mid-1980s, when hospital-specific payment rates and national payment rates per diagnosis-related group (adjusted for each area's input prices) were blended over a period of four years.
14. Massachusetts Health Care Quality and Cost Council. Roadmap to cost containment: Massachusetts Health Care Quality and Cost Council final report [Internet]. Boston (MA): HQCC; 2009 Oct 21 [cited 2013 Mar 29]. Available from: http://www .mass.gov/hqcc/docs/roadmap-tocost-containment-nov-2009.pdf
15. See Huang JT, Jacobson GA, Neuman T, Desmond KA, Rice T. Medigap: spotlight on enrollment, premiums, and recent trends [Internet]. Menlo Park (CA): Kaiser Family Foundation; 2013 Feb [cited 2013 Mar 29]. Available from: http://www.kff.org/medicare/upload/8412.pdf
16. Lieberman S. Reforming Medicare through "version 2" of accountable care, 2013. Unpublished paper.
17. Medicare Payment Advisory Commission. Report to the Congress: Medicare and the health care delivery system [Internet]. Washington (DC): MedPAC; 2012 Jun [cited 2013 Mar 29]. Available from: http://www.medpac.gov/documents/Jun12_EntireReport.pdf