Fwd: qotd: Brookings' disappointing recommendations for bending the cost curve

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-------- Original Message --------
Subject: qotd: Brookings' disappointing recommendations for bending the
cost curve
Date: Tue, 30 Apr 2013 11:46:53 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



Brookings
Engelberg Center for Health Care Reform
April 29, 2013
Bending the Curve
Person-Centered Health Care Reform: A Framework for Improving Care and
Slowing Health Care Cost Growth
Authors: Joseph Antos, Katherine Baicker, Michael Chernew, Dan Crippin,
David Cutler, Tom Daschle, Francois de Brantes, Dana Goldman, Glenn
Hubbard, Bob Kocher, Michael Leavitt, Mark McClellan, Peter Orszag, Mark
Pauly, Alice Rivlin, Leonard Schaeffer, Donna Shalala, Steve Shortell

We propose a framework for health care reform that focuses on supporting
person-centered care. With continued innovation toward more personalized
care, this is the best way to improve care and health while also bending
the curve of health care cost growth.

Simplify and Standardize Administrative Requirements
The time cost to clinicians of interacting with health plans has been
estimated to be as high as $23 to 31 billion annually. Further,
clinicians, health plans, and other participants in health care reform
are currently subject to a wide range of diverse reporting requirements
that add to costs and reduce the availability of actionable information.
Some steps have been taken recently to reduce these administrative costs
through standardization. Further administrative simplification steps
should include the following, all of which can be accomplished through
existing standard-setting entities and public-private implementation
initiatives:
* Implementation of an updated standardized claim form.
* Standard methods for quality reporting by providers and plans,
including clinical, outcome, and patient-level measures — this would be
an administrative benefit for providers that adopt value-based payment
reforms across all of their payment systems and would lead to reduced
reliance on cumbersome coding for specific types of providers.
* Standard methods for timely data sharing by plans with health care
providers and patients who are involved in the financing reforms
described in this report. Data sharing accomplished according to
consistent standards would reduce the burden on providers and patients,
and the it vendors who serve them, for implementing the analytic tools
needed to achieve greater improvements in care.
* Support for state investments to update their Medicaid information
systems including standard quality measure reporting and access to CMS
data for quality improvement.

Reforms for Private Health Insurance Markets and Coverage

* Support employer efforts to engage employees in reducing overall
health care costs through Employment Retirement Income Security Act
(ERISA) and other health plan regulations that promote value-based
insurance designs and tiered benefit designs, narrow networks of
providers that demonstrate high performance, and employees' ability to
share in the savings from health care choices and changes in behavior
that reduce costs.

Bending the Curve (49 pages):
http://www.brookings.edu/~/media/research/files/reports/2013/04/person%20centered%20health%20care%20reform/person_centered_health_care_reform.pdf


Comment: This newest report on recommending changes to control health
care costs is being presented as a "bipartisan" consensus representing
"broad agreement" on reform. Those who have followed the national policy
dialogue will recognize that the list of authors does, in fact, include
representatives of both major political parties. Nevertheless, the views
presented in the report confirms the presumption that these Democratic
authors have moved into the Republican camp in the policy debate.

As an example, their recommendations for reducing administrative waste
totally ignores the well documented sources of that waste, resulting in
recommendations that will have no impact at all on the problem, when
recovery of administrative waste should be front and center in reform.

As another an example of their right-wing approach, they recommend
"value-based insurance designs and tiered benefit designs, narrow
networks of providers that demonstrate high performance, and employees'
ability to share in the savings from health care choices and changes in
behavior that reduce costs." This is code language for consumer-driven
approaches that shift more costs to those needing health care - terrible
policies that defeat principles of health care justice.

The only good thing about this report is that you can quickly dump it
with the "delete" button, without the environmental consequences of
wasting 49 pages of paper.