Policy Experts Promote Cost-Containment

Former CMS Administrator Donald Berwick, MD, MPP and colleagues assembled by the Washington DC-based Center for American Progress have outlined a series of cost-containment proposals they believe should be implemented individually or together. These include negotiated payment rates that are binding on all payers; immediate adoption of bundled payment for cardiac and orthopedic procedures, with 75% of all Medicare and Medicaid payments made using alternatives to fee-for-service in ten years; competitive bidding for all Medicare financed commodities and for all exchange purchasing beginning in 2014; tiered offerings in all exchanges utilizing premium discounts; use of leveraged, pay-for-performance purchasing by exchanges; requiring providers to engage in electronic transactions with a single, uniform approach to physician credentialing; price information transparency; better use of non-physician providers; an expanded ban on physician self-referral; reform of the Federal Employees Health Benefits Program and use of evidence-based safe harbors as a shield for physicians from malpractice litigation. “A Systemic Approach to Containing Health Care Spending” appeared in the September 6, 2012 edition of the New England Journal of Medicine (www.nejm.org).