The federal government needs a plan for managing the various programs and projects that resulted and will result from recent healthcare legislation, argues a new report from the Commonwealth Fund Commission on a High Performance Health System (PDF), which offered its own take on how that plan could look.
The 24-page commission report, “ Performance Improvement Imperative: Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients,” suggests that the plan be first implemented among chronically ill patients with multiple conditions, a segment that represents a large chunk of healthcare spending.
The commission report also calls for a doubling of gains in quality-improvement metrics and limiting the per capita increase in spending to gross domestic product growth plus 0.5% by 2016, which would reduce national expenditures by $893 billion over 10 years. Enactment of the healthcare plan as suggested would contribute to an estimated $184 billion of those 10 year reductions, according to the report.
The commission plan also calls for creating a clear vision and goals for performance improvement, collaboration on priorities, simplification of administration and rapid feedback. “The very number and diversity of new legislative authorities, each with its own legal quirks and restrictions, creates huge conceptual and logistical complexity,” the authors wrote. “It does not help that responsibility for implementing critical programs is spread across a stunning array of large agencies within and beyond the Department of Health and Human Services.”
That plan also suggest that HHS and the CMS create 50 to 100 voluntary “health improvement communities” that are committed to improving care for complex, high-cost patients, sometimes in concert with accountable care organizations.
The commission was created in order to try to provide “national leadership to revamp, revitalize, and retool the U.S. healthcare system,” according to its website.