Report: U.S. Could Save $1T via Integrated Care, Ending Fee-for-Service

The federal government could save $300 billion over a decade and as much as $1 trillion over two decades by further using integrated care models and shifting away from fee-for-service payment systems, according to a report from the Brookings Institution, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 4/29).

The bipartisan report -- titled "Bending the Curve" -- was co-authored by more than a dozen health and economic experts, including former Senate Majority Leader Tom Daschle (D-S.D.), former Office of Management and Budget Director Peter Orszag and former HHS secretaries Michael Leavitt and Donna Shalala (Reichard, CQ HealthBeat, 4/29).

The report calls for phasing out the Medicare fee-for-service payment system over the next 10 years and replacing it with a "comprehensive-care" system based on quality and patient outcomes. The authors say per-beneficiary spending growth should be limited to per-capita gross domestic product growth, which they estimate would save $120 billion from 2019 to 2023.

To reform Medicaid, the report recommends an increased focus on coordinated care and lower cost growth, which the authors estimate would save $100 billion over 10 years.

For those individuals eligible for both Medicaid and Medicare, the paper suggests making permanent a demonstration project designed to streamline costs and care improvements (Block, Modern Healthcare, 4/29).

The report urges federal officials to issue universal standards for cost and quality transparency that can be used by both public and private insurers.

According to "Healthwatch," the report's proposals also address a wide variety of other issues, including Medicare Advantage, liability reform and licensing barriers.

According to the report, the proposals already have "broad agreement" between Democrats and Republicans and should be used as a "foundation" for future health care reforms ("Healthwatch," The Hill, 4/29).