Women's Health Professional

Today's Date: Wednesday, March 10, 2010

Healthcare Leaders Say Payment Reform Needed To Control Costs

Tuesday, May 05, 2009

Healthcare leaders believe the U.S. must rein in
the growth of health spending, majority of respondents call for payment reform.

Nearly all respondents, 96 percent, to the latest Commonwealth Fund/Modern Healthcare “Health Care Opinion Leaders Survey” agreed that spending must slow and large majorities expressed support for a range of strategies to reduce costs, including many of those outlined in President Obama's budget blueprint.

Currently, the nation as a whole spends 17 percent of gross domestic product (GDP) on healthcare; that proportion is projected to grow to 21 percent by 2020, said Commonwealth.

"Although the United States spends more than any other country on health care, too many Americans are still falling through the cracks,” said Karen Davis, Commonwealth Fund president.

"These survey results show substantial consensus among leaders on the need to control healthcare costs while fundamentally transforming our healthcare system to one that provides affordable high-quality coordinated care for all Americans."

Specifically, opinion leaders voiced strong support for various aspects of payment reform, including moving away from 'fee-for-service' payment toward ‘bundled’ payment (70 percent), aligning Medicare Advantage rates with those paid in traditional Medicare (77 percent), and providing greater incentives for high performance care (87 percent).

Having Medicare negotiate prescription drug prices was supported by 82 percent of respondents, including 76 percent of respondents from business, insurance, and other healthcare industries.

Promoting the growth of integrated delivery systems (62 percent), increasing payments or primary care and medical homes (61 percent), and establishing a center for comparative effectiveness (54 percent) also were widely supported, as were replacing the Medicare Sustainable Growth Rate mechanism with fundamental provider payment reform (66 percent), introducing competitive bidding for durable medical equipment (91 percent), and negotiating pharmaceutical drug prices (82 percent).

Respondents showed little support for liability reform or greater cost sharing by patients, The Commonwealth said.

Other findings from the survey include:

Of the proposals outlined in President Obama's budget blueprint, experts were nearly unanimous in their support for reforming the physician payment system to improve quality and efficiency (97 percent) and establishing a streamlined approval system for generic drugs and preventing drug companies from blocking the introduction of generic competitors (94 percent).
The impetus for information technology and comparative effectives provided by the American Recovery and Reinvestment Act also found support from health care opinion leaders. Half (54 percent) thought establishing a center for comparative effectiveness would be effective in reducing the growth in healthcare costs and half (50 percent) also thought providing funding to accelerate adoption of health information technology, promote uniform standards for interoperability, and establish health information exchange networks would be effective.
Almost three quarters (72 percent) supported narrowing the prices paid by private insurers, Medicare, and Medicaid by gradually bringing up payment levels in the public programs and lowering commercial insurer payment rates. Fifty-five percent supported reducing payment updates for providers in high-cost geographic areas.
While a minority, two-fifths of opinion leaders thought that all-payer rate setting would be effective in controlling costs while maintaining quality. Fewer than 1 in 5 experts (18 percent) believe requiring patients to pay a substantially higher share of their health care costs would be an effective or extremely effective way to reduce avoidable, duplicative, or unnecessary utilization of health care services, and just 23 percent supported requiring prior authorization for expensive or high-volume services.

For more information, please visit: www.cmwf.org.

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