A plan developed by the
Brookings Institution would dampen health spending in the next decade, part by moving away from fee for service and toward a system in which providers receive fixed, capitated reimbursement and take on risk.
The plan, released April 29, has bipartisan backing. Democrats supporting it include former Senate Majority Leader Tom Daschle, former White House Office of Management and Budget Director Peter Orszag and former HHS Secretary Donna Shalala, the newsletter CQHealthBeat reports. Republican backers include former HHS Secretary Michael Leavitt, former Congressional Budget Director Dan Crippen and former CMS head Mark McClellan., former administrator of the Centers for Medicare and Medicaid Services, and Katherine Baicker of the Harvard School of Public Health, who served as an economist in the Bush White House.
The plan would be a useful starting point when the pressure of the sequester cuts “becomes big enough that something is compelled to happen,” Leavitt commented. “When it does, there needs to be a proposal that Republicans and Democrats can in fact agree upon.”
The authors said their proposal would save $300 billion in its first decade but more than $1 trillion after the second decade. The authors said the plan also would set the health system on a path to overall health spending that grows at gross domestic product (GDP) “plus zero.”
The Medicare comprehensive care organizations include collaborations of providers that receive a globally capitated, comprehensive payment for their attributed beneficiaries and must meet a set of care quality and outcome performance measures for full payment, the proposal says. The initial benchmark for Medicare comprehensive care would be based on current beneficiary spending and quality of care. Over time the spending target would be based on GDP.