Founded by former Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell, the Bipartisan Policy Center is a nonprofit organization seeking to bridge partisan divides and find common ground solutions in a variety of issue areas. BPC is unique for combining politically balanced policymaking with strong, proactive advocacy and outreach.
Objective: Bipartisan Policy Center (BPC) brought together four of the nation's leading health and budget experts to start a constructive, meaningful dialogue on strengthening the U.S. health care system. Former Senate Majority Leaders Tom Daschle and Bill Frist, former Senate Budget Committee Chairman, Pete Domenici, and former Director of the Congressional Budget Office and the Office of Budget and Management Alice Rivlin set out to produce a package of comprehensive, systemic reforms to achieve a higher-value, higher-quality health care system through more coordinated, organized systems of care. The report largely focuses on Medicare and federal tax policy as critical levers for change, recognizing that Medicare policies often lead the way to private sector reforms. This effort was largely built on the premise that budget-driven efforts to achieve health care savings alone will inevitably fail. A strong health care system, a stable federal budget, and a productive economy are complementary, not competing, priorities.
Process: The policies embody the BPC approach, produced by nearly a year of rigorous analysis, reasoned negotiations, and respectful dialogue. The process included extensive stakeholder outreach, thorough research, and substantive, credible third-party analytics to quantify the impact of the policies. Staff benefited from the depth of knowledge and expertise of project senior advisors Sheila Burke, Chris Jennings, Paul Ginsburg, and Steve Lieberman.
Methodology: In the long-term, the policies envision health care that is value-driven and coordinated through organized systems of care, in which providers are accountable for quality and costs and beneficiaries are fully engaged. With this report, we believe we present a palatable, bipartisan approach to systemwide payment and delivery system reform. BPC's leaders strove to develop politically viable and policy sound proposals, prioritizing political and economic realities and seeking options that both sides of the aisle could realistically coalesce around. To model the budgetary impact of the proposals, BPC hired analytics firm Acumen, LLC, which works with Medicare Payment Advisory Commission, Congressional Budget Office, and the Institute of Medicine, and has access to full Centers for Medicare and Medicaid claims data. The savings estimates were an outgrowth, rather than the underlying goal, of the proposed reforms.
Total savings: If enacted, these policies would reduce the federal deficit by an estimated $560 billion over the next 10 years, including nearly $300 billion in Medicare savings, which includes the cost of a permanent fix to the sustainable growth rate (SGR) formula for physician payments and the cost of increased assistance to low-income beneficiaries. As the reforms take full effect, we expect Medicare savings will approach $1 trillion in the second 10-year window.
Other related work: This cost containment work is a joint initiative of BPC's Health and Economic Policy Projects, committed to bringing together policymakers and industry stakeholders for substantive collaboration in support of creating a more sustainable, accountable and efficient health care system. This work is also enhanced by complementary BPC initiatives in the areas of health information technology, the health professional workforce, and prevention and public health.
BPC continues to encourage vigorous discussion about the strategy and implementation of these proposed cost containment reforms through outreach and education. To further support our leaders' vision for a more coordinated and accountable health care system, the BPC Health Project will focus on the implementation of new models of health care delivery and payment, and the evolution and evaluation of those systems over time. We will also explore long-term care delivery and financing, an issue we were not able to address in depth in the report, and that we see as a natural and worthwhile continuation of the health care cost containment work.
For additional information on BPC's report please see:
Thomas Daschle, Pete Domenici, William Frist, and Alice Rivlin. "Prescription for Patient-Centered Care and Cost Containment" New England Journal of Medicine July 26, 2013 http://www.nejm.org/doi/full/10.1056/NEJMsb1306639
Testimony of Dr. Alice Rivlin, co-leader, BPC Health Care Cost Containment Initiative. House of Representatives Committee on Ways and Means, Subcommittee on Health. May 21, 2013 http://bipartisanpolicy.org/sites/default/files/Alice_Rivlin_Testimony%20May%202013.pdf
For more detailed description of policies in this report, please see:
"A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment" Bipartisan Policy Center, April 18, 2013 http://bipartisanpolicy.org/library/report/health-care-cost-containment