Bending the Curve III
Patient-Centered Health Care Reform: A Framework for Improving Care and Slowing Health Care Cost Growth

The Initiative for Health Care Innovation and Value at the Brookings Institution provides practical solutions to achieve high-quality, innovative, affordable health care with particular emphasis on identifying opportunities on the national, state, and local levels. In addition to making policy recommendations, the Initiative also facilitates the development of new consensus around key issues and provides technical support to implement and evaluate new solutions in collaboration with a broad range of stakeholders. Substantive areas of expertise include payment and delivery system reform, quality improvement, health care innovation, and health reform implementation. The Bending the Curve report ties together many of the areas of health care reform analysis and support at Brookings.

Objective: To propose a framework that supports person-centered health care reform across the U.S. health care system—Medicare, Medicaid, private health insurance, and systemwide regulation—to improve health care quality and consequently reduce health care costs. Proposed reforms provide a path to achieve innovative, person-centered care while sustaining per-capita cost growth in line with growth in per-capital gross domestic product.

Process: Deliberations by coauthors (see roster) from April 2012 to April 2013, supported by technical analysis by Brookings staff. General recommendations developed by consensus.

Methodology: Potential savings of policies in each of the four categories—Medicare, Medicaid, private health insurance, and systemwide—were estimated using simulations of reforms based on data and estimates from published sources, including the Congressional Budget Office and the Office of Management and Budget, augmented by input and review from the Bending the Curve authors and budget experts.

Total savings: Estimated net federal savings of $300 billion or more in the next decade (2014–2023) and long-term savings estimated to exceed $1 trillion over 20 years.

For more detailed description of policies in this report, please see:

Bending the Curve: Person-Centered Health Care Reform, Brookings Institute, April 2013.


Joseph Antos, American Enterprise Institute for Public Policy Research

Katherine Baicker, Harvard School of Public Health

Michael Chernew, Harvard Medical School

Dan Crippen, National Governors Association

David Cutler, Harvard University

Tom Daschle, Former U.S. Senate Majority Leader from South Dakota

Francois de Brantes, Health Care Incentives Improvement Institute

Dana Goldman, University of Southern California

Glenn Hubbard, Columbia Business School

Bob Kocher, Venrock

Michael Leavitt, Leavitt Partners

Mark McClellan, The Brookings Institution

Peter Orszag, Bloomberg

Mark Pauly, The Wharton School of University of Pennsylvania

Alice Rivlin, The Brookings Institution

Leonard Schaeffer, University of Southern California

Donna Shalala, University of Miami

Stephen Shortell, University of California, Berkeley School of Public Health and Haas School of Business