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Coalition members are deeply concerned about the paucity of delivery system reform language in many of the current legislative proposals and urges that alternatives to fee for service (FFS) be adopted to offer stronger incentives to align payment to quality, reward providers and hospitals that are doing what’s right for patients, and making health care more efficient and less costly. Support for adoption of these alternatives assumes that patient protections and quality assurance mechanisms are in place to meaningfully protect patient care.

      Certain forms of bundling and other delivery reforms—if appropriately formulated—seem likely to fit well into the evolving policy framework. Expedited adoption of such reforms many of which are now being tested in demonstration and pilot programs—provided they are designed in a way that reflects the interests of patients, consumers, and providers—could also be linked to a short-term savings trigger. However, a more cautious approach should be taken with bundling demonstrations and pilots of post acute care services for people with disabilities and chronic conditions to ensure that they receive medically necessary services at the appropriate level of intensity. It should be noted that a number of Coalition members strongly encourage permanent repeal of the Sustainable Growth Rate (SGR) provisions and new legislation to better address the quality and value delivery issues. SGR presents too many problems as formulated and presents too great a risk of misapplication and inequitable cuts while failing to recognize quality.

From Rx for Reform

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The National Coalition on Health Care’s recommendations, based upon the consensus view of 85 member organizations, to make the system less complex, reduce overly high prices, and create a truly competitive health care marketplace. The goal of the paper is to augment the NCHC Principles and Specifications with a more detailed and selective set of policy recommendations on cost containment and quality improvement.

From Facts & Research

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CostDelivery System ReformsInsurance

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CostCoverageDelivery System ReformsEconomic Impacts

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Issue Area(s):

CostCoverageDelivery System ReformsPolicy Implementation

Issue Areas

U.S. health care spending hit an unprecedented 17.6 percent of the GDP in 2009.

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