Health reform bills could improve quality and efficiency, but fall short of national plan

inated policy strategy with national goals to guide improvement efforts, establish priorities, ensure implementation of effective strategies and monitor their impact.
  • Fundamental payment reform that moves away from the current fee-for-service model and emphasizes paying for care coordination and population- or episode-based care and reducing the differential between high payment for procedures and relatively low payment for primary care services.
  • Creation of an entity such as a National Quality Coordination Board, as recommended by the Institute of Medicine, to ensure that public and private efforts reinforce each other.
  • Creation of a center that would offer comparative effectiveness information for drugs, devices and procedures.
  • Reorienting the health care system to encourage prevention, early primary care, and chronic disease management, including patient designation of a patient-centered primary care home.
  • Access for patients to their own medical records, along with patient information and tools to share in decision-making.

    According to Davis and co-author Sara Collins, assistant vice president at The Commonwealth Fund, significant improvements in quality will require greater federal involvement in health care, not only in financing insurance coverage but also in the enhancement of federal programs and policies aimed at improving health system performance. By focusing on quality improvement and efficiency, the government and the private sector can get a better return for their substantial investment in health care, according to the analysis.

    Legislative proposals that would reform the payment structure for health care services are likely to lead to real improvements in quality and the most likely to lead to savings in the health system, according to the analysis. Early evidence from pay-for-performance initiatives indicate that even modest financial incentives for hospitals contribute to improve

  • Contact: Mary Mahon
    Commonwealth Fund

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