“We believe our health system will generate better value when consumers and providers face aligned incentives—based on evidence of what works—that reward quality care and efficient use of resources,” David Lansky, president and CEO of the Pacific Business Group on Health, said in a statement. Other partnership members include America's Health Insurance Plans, Ascension Health and Families USA.
The group also recommends that payers embrace a tiered reimbursement strategy that provides higher payments for services deemed more effective. Also, they say insurers and government health programs should cut payment for services shown to be less effective and a poorer value compared with other therapies.
The partnership also calls for establishing a set of quality and performance measures used to foster provider payment reform, as well as incentives for consumers and more competition in healthcare markets.
States must also be incentivized to improve care, the group says, which includes forming a gain-sharing program for them to promote approaches to quell rising healthcare costs. For example, states would set a savings goal, and if they slow spending growth by that amount, they would be rewarded by sharing in some of those savings.
“To meet America's healthcare needs, with special attention to the poor and vulnerable, we know that healthcare providers must fundamentally reconfigure delivery systems, care processes and cost structures,” Ascension Health CEO Robert Henkel said in a statement. “Moving to managing the health of defined populations demands recognition and acceptance of the magnitude of the transformational change required.”
The Partnership for Sustainable Health Care is supported by the Robert Wood Johnson Foundation.
Follow Jonathan Block on Twitter: @MHjblock