Some of the nation’s top health care experts, several of whom helped write the 2010 health care law, released a strategy Wednesday to take the next step — curbing spending.
The proposals include state spending targets; competitive bidding for medical devices, laboratory tests and other Medicare services; and a dramatic move away from the traditional way doctors and hospitals are paid.
They were the consensus of a group of 23 mainly centrist and left-leaning economists, academics and former Obama administration officials, including Peter Orszag, former director of the Office of Management and Budget,and Ezekiel Emanuel, who served as health policy adviser to the OMB. Emanuel was the chief author of the report, which was published in the New England Journal of Medicine.
The group was convened by the Center for American Progress (CAP), a liberal think tank, and met in January for a daylong session to discuss policy options for slowing health costs.
Among the group’s ideas:
– Creating independent panels made up of medical providers, employers, consumers in each state that would set spending targets, which would ultimately be tied to that state’s average growth in wages.
– Encouraging negotiations among public and private insurers along with hospitals, doctors and other medical providers, to set payment rates that would apply to all providers in a state.
– Extending competitive bidding in Medicare, which is now limited to some medical equipment, such as wheelchairs, to many medical devices, lab tests and imaging services.
– Moving rapidly to get Medicare and private insurers to move away from paying piecemeal for each test or procedure to a model that “bundles” payments that would cover a broad range of care.
The hope is the plan, which could be implemented in whole or in part, will get attention in Congress as it debates deficit reduction efforts later this year, said Topher Spiro, managing director of health policy at CAP. Some of the changes would require federal action.
Economist Paul Ginsburg of the Center for Studying Health System Change, who was not part of the group that drafted the paper, sees it as an outline of ways to expand upon the more limited cost containment efforts in the 2010 federal law.
Some of the ideas might find favor mainly in so-called blue states. But other elements, such as competitive bidding and making payment changes for both government programs and private insurers, could appeal to businesses and more conservative states, said Spiro.
The ideas garnered support from Walmart, the nation’s largest retailer, according to a press release from CAP.
“These principles are a strong foundation that can set the U.S. health care system on a path of sustainable growth,” Sally Welborn, senior vice president of benefits at Walmart, said in a written statement.