Two key administration officials today lauded cost-containment provisions included in dual healthcare reform bills despite criticism from some who charge that the legislative packages would lead to higher costs, not lower. White House budget chief Peter Orszag and Nancy-Ann DeParle, director of the White House Office of Health Reform, said that both bills lay the groundwork for sweeping changes in how care is delivered and paid for across the country.
The Senate bill includes a number of pilot programs and test groups that aim to eventually change how providers are paid. But a lack of attention to cost containment over the years has hindered current efforts, Orszag said, adding, “We don't have full knowledge of how to design and implement and go to scale immediately on all such proposals.” Programs outlined in the bills, such as bundled payment pilots and the creation of accountable care organizations, are intended to help “learn more specifically exactly what parameters work and don't work to encourage an emphasis on quality rather than intensity.”
Orszag also outlined four steps that are needed to move healthcare forward, including the widespread use of health information technology, evidence-backed clinical research, payment system reforms and a Medicare commission that would work to implement and fine-tune such components. The Congressional Budget Office has estimated that the Senate's bill would reduce the federal deficit by $130 billion over the next decade—a number that DeParle said is conservative. “I think the changes that will occur in this bill will be broader and deeper than what the Congressional Budget Office and even our colleagues” at the Office of Management and Budget are anticipating, she said. “And I think that has been our experience in the past."