Priority #1: Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.
Examples of Federal Initiatives Related to Priorities:
- Establishing Health Insurance Exchanges: Starting in 2014, State-based health insurance exchanges will lower costs and improve health care quality for individuals and small business owners by creating a more transparent and competitive marketplace. http://www.hhs.gov/news/press/2011pres/01/20110120b.html
- Fostering Innovations to Promote Quality and Reduce Cost: The Affordable Care Act established a new Centers for Medicare & Medicaid [CMS] Innovation in CMS, charged with testing innovative payment and service delivery models in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) that improve care and save money. http://innovations.cms.gov/.
- Administrative Simplification: The Affordable Care Act includes provisions to foster "administrative simplification." Under those provisions, new tools will be adopted to help doctors and other providers focus on patients instead of paperwork, such as a standard unique identifier for health plans, a new standard for electronic funds transfer, and operating rules that provide more specificity to existing transaction standards.
Initial Goals, Opportunities for Success, and Illustrative Measures:
Goal: Identify and apply measures that can serve as effective indicators of progress in reducing costs.
Opportunities for success:
- Build cost and resource use measurement into payment reforms.
- Establish common measures to assess the cost impacts of new programs and payment systems.
- Reduce amount of health care spending that goes to administrative burden.
- Make costs and quality more transparent to consumers.
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