Study provides details about key components of health reform

Aug. 21, 2009

Washington, D.C. – In response to increasing concerns in the health care debate regarding the long-term costs of reform, the Bipartisan Policy Center (BPC) today released a report examining various steps for reforming the health care system to one that delivers better care at lower costs.

The report, entitled, "Improving Quality and Value in the U.S. Health Care System," supports the bipartisan health reform recommendations released earlier this year by Senators Howard Baker, Tom Daschle and Bob Dole in their budget-neutral framework for comprehensive health reform, "Crossing Our Lines: Working Together to Reform the U.S. Health System."

"It's too costly just to cover the uninsured in our current health care system," said Dr. Mark McClellan, co-director of the BPC's Leaders' Project on the State of American Health Care. "As part of health care reform, we can improve the way our health care system works for all Americans, whether they are covered by private plans, by Medicare, or by Medicaid. For example, we must move the focus away from paying more for more services, and toward paying more for better results."

The report reviews evidence on a range of delivery system and related reforms designed to improve health care quality and value. It reaches five main conclusions:

• Delivery system reforms, like chronic disease management, primary care coordination, and health information technology may not only improve health outcomes but also reduce costs
• Targeted interventions to particular patient populations or clinical areas are more effective in improving quality and reducing costs than broader interventions
• Multiple delivery reforms must be integrated and linked to overall accountability to achieve real results
• Payment and benefit reforms are critical to the success of quality and value reforms
• Quality and value-increasing delivery reforms and coverage expansions can have complementary, mutually reinforcing effects on overall health system performance

"We have to fundamentally change the way we think about health care," said Matt Canedy, BPC's Director of Health Policy. "Effective reforms will require a new approach health care policy. Resources should follow outcomes and accountability should become an essential part of medicine. It's the only way all Americans will get the health care they need."

In June, Senators Baker, Daschle and Dole, who are members of the BPC"s Advisory Board and the Leaders’ Project on the State of American Health Care, released a bipartisan, budget-neutral blueprint for comprehensive health reform that ensures every American has access to affordable, quality health coverage. The report, "Crossing Our Lines: Working Together to Reform the U.S. Health System", offers realistic, politically-viable policy recommendations to address the key delivery, cost, coverage and financing challenges facing the nation’s health care system. The BPC hopes its latest report on improving health care quality and value will support Congress' ongoing work to craft comprehensive health reform legislation that helps set the nation’s health system on a fiscally-viable path for generations to come.

The report advocates several points that are meant to bolster the specific policy recommendations made in Crossing Our Lines:

1. Include Medicare in delivery reform. Major impacts on medical practices are not possible without changes in Medicare. Policy makers must implement Medicare improvements that transition payments to promote greater accountability.
2. Develop and promote the consistent, meaningful use of valid and widely available information on the quality and cost of health care. Emphasize measurement in outcomes and costs, use health information technology to simplify collection and reporting, and build better evidence on best delivery approaches.
3. Promote an integrated approach to delivery reform by supporting the efforts of providers to organize care locally and be accountable for the overall quality and costs for their patients.
4. Encourage state and regional efforts in which public and private payers collaborate on initiatives to improve the value of care.

---

---

Leaders' Project on the State of American Health Care