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Bending the Curve

Bending the Curve

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Published by Brian Ahier

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Published by: Brian Ahier on Oct 30, 2009
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06/25/2010

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QUALITY. INDEPENDENCE. IMPACT.
Bendingthe Curve
Effective Steps to AddressLong-Term Health CareSpending Growth
 
 J
oseph
 ntos
, p
h
D
 Wilson H. Taylor Scholar in Health Careand Retirement Policy  American Enterprise Institute orPublic Policy Research
 J
ohn 
B
ertko
 Visiting Scholar The Brookings Institution
 M
ichAel
c
hernew 
, p
h
D
Proessor o Health Care Policy in the Department o Health Care Policy Harvard Medical School
D
 AviD
c
utler 
, p
h
D
Otto Eckstein Proessor o Applied Economicsin the Department o EconomicsHarvard University 
D
 AnA 
G
olDMAn 
, p
h
D
Norman Topping Chair in Medicine andPublic Policy Schools o Pharmacy and Policy,Planning, and DevelopmentUniversity o Southern Caliorniaand RAND Corporation
 M
 Ark 
M
c
c
lellAn 
, MD, p
h
D
Director, Engelberg Center or Health Care ReormLeonard D. Schaeer Chair in Health Policy Studies The Brookings Institution
e
lizABeth
M
c
G
lynn 
, p
h
D
 Associate Director, RAND HealthDistinguished Chair in Health Quality Senior Principal ResearcherRAND Corporation
 M
 Ark 
p
 Auly 
, p
h
D
Bendheim ProessorProessor o Health Care ManagementUniversity o Pennsylvania
l
eonArD
s
chAeffer 
 Judge Robert Maclay Widney Chair and ProessorUniversity o Southern Caliornia
s
 tephen 
s
hortell
, p
h
D
Dean, School o Public HealthBlue Cross o Caliornia Distinguished Proessoro Health Policy and ManagementUniversity o Caliornia, Berkeley 
Bending the Curve
Effective Steps to Address Long-Term Health CareSpending Growth
AUGUST 2009
The Egelberg Ceter r Health Care Rer s ctte t rucg ate slutsthat ll re rer  ur at’s health care syste. The Ceter’s ss s t eelata-re, ractcal lcy sluts that rte bra access t hgh-qualty, arable,a ate care  the Ute States. The Ceter cucts research, akes lcy rec-eats, a acltates the eelet  e csesus aru key ssues a restechcal surt t leet a ealuate e sluts  cllabrat th a bra rage stakehlers.
Developed with support from the Robert Wood Johnson Foundation
 
Bending the Curve
  
EffECTivE STEpS To AddRESS LonG-TERm HEALTH CARE SpEndinG GRowTH
 
R
educing the growth o health care spending isa top priority o Congress and the Adminis-tration, but identiying specic, easible stepsthat can achieve this goal has proven dicult. Whilethe political debate has ocused on several conten-tious issues, we believe there is a set o sustainablesteps that together can slow spending growth sig-nicantly while building the high-value health caresystem our nation urgently needs. In combination with steps to cover the uninsured, reorms to con-strain spending growth are easible and essential orthe nation’s scal stability and economic well-be-ing. These steps are not meant to be exhaustive, butrather a set o mutually-reinorcing reorms that we collectively agree could lead to signicant re-ductions in costs and spending growth and improvequality o care at the same time. I implementedtogether, the impact on spending growth could besubstantial. Some o these steps will generate re-ductions in spending in the short run. Others may take more time to have an impact, but hold morepromise or reducing the rate o increased spendingover time. Many o these steps work together to address a crit-ical faw in American health care policies today: thelack o accountability or costs and results. Provid-ers, patients, insurers, employers, and governmentsall participate in a system with little incentive — oroten adverse nancial consequences — to improvequality or reduce overall costs. Transitioning to asystem o greater accountability will require greaterfexibility or private and public stakeholders to ex-periment with programs and measure results, to see what works best.First, as a oundation or improving value, all stake-holders in the system need
better inormation and tools
to be more eective. Second,
provider payments
should be redirected toward rewardingimprovements in quality and reductions in costgrowth, providing support or health care delivery reorms that save money while emphasizing diseaseprevention and better coordination o care. Third,
health insurance markets
should be reormedand government subsidies restructured to createcompetition and improve incentives around valueimprovement rather than risk selection. This steprequires near-universal participation in insurancemarkets to succeed. Finally,
individual patients
should be given greater support or improving theirhealth and lowering overall health care costs, in-cluding incentives or achieving measurable healthgoals. Specic steps to accomplish these goals ol-low.
ioco

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