BCBS Releases List of Recommendations To Curb Health Spending
On Tuesday, the Blue Cross and Blue Shield Association released a list of recommendations that the insurer says would improve care quality and reduce federal health care spending by about $319 billion over a decade, National Journal reports (McCarthy, National Journal, 10/4).
The 20 recommendations focus on rewarding safety, implementing effective practices, reinforcing front-line care and promoting healthy living (Zigmond, Modern Healthcare, 10/4).
BCBS CEO and President Scott Serota said the federal government needs to move quicker to implement new payment structures that are currently in demonstration mode under the federal health reform law.
The proposal suggests that high-performing hospitals be rewarded with bonus payments, while poor-performing hospitals receive lower payments. The plan also calls for moving the nine million U.S. residents eligible for both Medicaid and Medicare into managed care programs.
Kenneth Thorpe -- a former HHS official for the Clinton administration -- prepared the proposal, which detailed the savings based in part on Congressional Budget Office projections.
The proposal -- which includes some recommendations that would need legislation and others that could be done administratively by CMS -- states that over 10 years the federal government could save:
- $3 billion by accelerating the adoption of safety measures in the value-based purchasing program;
- $21 billion by expanding a bundled payment program to cover all inpatient Medicare discharges by 2020;
- $125 billion by coordinating care for dual eligibles;
- $7 billion through lifestyle change programs;
- $3 billion through a childhood prevention program;
- $1 billion by requiring pre-authorization of advanced imaging services in Medicare for certain physicians; and
- $54 billion by putting caps on non-economic and punitive damages and a shorter statute of limitations in the medical malpractice system (Norman, CQ HealthBeat, 10/4).
Prospects for Changes
According to National Journal, the debt panel created by the recent budget deal is the "only forseeable vehicle" for the changes to Medicare and Medicaid suggested in BCBS' proposals, but it is unlikely there is enough time to consider serious payment changes.
However, Serota said, "The super committee creates an opportunity, but it isn't the only opportunity," adding, "We're not going to stop when they stop because frankly, the issue is bigger than the super committee" (National Journal, 10/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.