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Recent Health Reform Proposals Lack Overall 'Game Plan'

A Commonwealth Fund analysis of major health reform bills before Congress concludes that while several could lead to significant improvements in quality and efficiency, each falls well short of a comprehensive strategy for overhauling the nation's health care system.

Prepared for the Fund's Commission on a High Performance Health System, the report finds that proposals targeting reform of the payment structure for health care services are likely to lead to real improvements in quality and figure to produce health system savings. But none of the analyzed bills presents an overarching vision for the U.S. health system. "There is no question that the leading health care bills introduced into Congress in the past two years are important steps toward addressing serious deficiencies in this country's health care system," said Karen Davis, the Fund's president and the study's lead author. "Yet taken as a whole, they leave important gaps."

Davis and her coauthors recommend a coordinated policy strategy to establish national priorities, guide improvement efforts, and ensure implementation of effective strategies. They also call for payment reform that promotes care coordination and population- or episode-based care; creation of a national center that would provide information on the comparative effectiveness of drugs, medical devices, and procedures; and reorientation of the health system to encourage prevention, early primary care, and chronic disease management through each patient's medical home.

The first report in the two-part series, An Analysis of Leading Congressional Health Care Bills, 2005-2007: Part I, Insurance Coverage, analyzed the likely effect on health system performance of congressional legislative proposals to extend health insurance coverage.

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