Congress Must Set Goals for High Performance by 2020

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<p>Congress is considering various health reforms as bills emerge from key committees, and as Republican alternatives are released. In a <a href="/Content/Blog/National-Leadership-to-Achieve-a-Performance-Driven-Health-System.aspx">new blog post</a>, Commonwealth Fund President Karen Davis and Executive Vice President Steve Schoenbaum, M.D., say that what is largely missing from these proposals, however, is an overarching framework that establishes health system goals and includes a coordinated set of public policies and private sector actions that would ensure the U.S. reaches benchmark levels of health system performance by 2020. "Without a mechanism for setting long-range goals as well as immediate priorities for performance improvement," they argue, "we could fail to realize the enhanced impact and economies possible from concerted action." <br /><br />The authors suggest that the publication of an annual "Health Performance Report," submitted to Congress by the President, would be one way to reach agreement on national performance goals and improvement targets with the government's imprimatur, along with supporting policies, resources, and actions. Congress would act annually to accept and/or modify these goals and priorities, and make the policy changes needed to help achieve them. <br /><br />Examples of possible health system performance goals for 2020 and indicators to measure shorter-term improvement include: </p>
<strong>2020:</strong> The U.S. is in the top five countries in achieving desired health outcomes for its population. <strong>Shorter-term indicator: </strong>Percent of population receiving key preventive services or screening. </li>
<strong>2020: </strong>All Americans have the opportunity to be covered by an affordable health plan that ensures that premiums and out-of-pocket expenses do not exceed an affordability standard. <strong>Shorter-term indicator: </strong>Percent of population insured. </li>
<strong>2020:</strong> Health spending over 2010–20 is slowed by 1.5 percentage points a year from 2009 rate of increase. <strong>Shorter-term indicator: </strong>Percent of provider revenue that replaces fees-for-services with value-based payment for bundles of care. <br /></li>