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You Can’t Have One Without the Other: Bending the Healthcare Cost Curve & Financing Health Reform. Rachel Nuzum Senior Policy Director, The Commonwealth Fund Alliance for Health Reform Briefing July 31, 2009 rn@cmwf.org www.commonwealthfund.org. 6.5% annual growth. 5.2% annual growth.
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You Can’t Have One Without the Other: Bending the Healthcare Cost Curve & Financing Health Reform Rachel Nuzum Senior Policy Director, The Commonwealth Fund Alliance for Health Reform Briefing July 31, 2009 rn@cmwf.org www.commonwealthfund.org
6.5% annual growth 5.2% annual growth 4.6% annual growth THE COMMONWEALTH FUND Total National Health Expenditures (NHE), 2009–2020:Current Projection and Alternative Scenarios NHE in trillions $5.0 $4.4 $4.1 $2.5 Source: C. Schoen, K. Davis, S. Guterman, and K. Stremikis, Fork In the Road: Alternative Paths to a High Performance U.S. Health System, The Commonwealth Fund, June 2009.
Sources of Path Savings, Net Impact on Federal Budget and National Health Expenditures Compared to Baseline, 2010–2020 (in billions) Source: The Commonwealth Fund Commission on a High Performance Health System, The Path to a High Performance Health System: A 2020 Vision and the Policies to Pave the Way, The Commonwealth Fund, February 2009.
Savings Can Offset Federal Costs of Insurance:Federal Spending Under Two Scenarios Dollars in billions Data: Estimates by The Lewin Group for The Commonwealth Fund. Source: The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way, February 2009.
Implications for Stakeholders • Coverage and Savings • Coverage for all with $3.0 trillion system savings 2010-2020 with public health insurance plan; $0.8 trillion without • Coverage for all with $200 billion federal budget cost 2010-2020 with a public health insurance plan; $700 billion without • Employers and Employees • Public health insurance plan more affordable than premiums now in small business market: 20-30% lower premiums • Savings to employers including payment and system reforms of $231 billion over 2010-2020 • Providers • Provider revenues enhanced by increasing Medicaid payment to Medicare levels and buying in uninsured at Medicare rates • Payment reforms reward primary care and high performers but slower revenue growth over time than current law • Insurers • Rewards integrated delivery system and private insurers that enhance value • Administrative savings of $337 billion over 2010-2020
Key Considerations • Important to focus on both federal budget costs and total health spending • Payment and delivery system reforms are needed to bend the health care cost curve • Aligning patient and provider incentives to reward high value, effective care is important • Need for a mechanism to measure and monitor progress
Thank You! Steve Schoenbaum, Executive Vice President Karen Davis, President Stu Guterman, Assistant Vice President Cathy Schoen, Senior Vice President Stephanie Mika, Program Associate