The complete report is also available.
Spurred on by the recognition that the United States is on an unsustainable trajectory for health spending at the same time that the numbers of uninsured and underinsured continue to rise, the Commonwealth Fund Commission on a High Performance Health System released a new report demonstrating that it is possible to achieve affordable, universal coverage while improving health outcomes and slowing the rate of national health spending, by a cumulative $3 trillion through 2020.
What Are the 'Path' Reforms?
The report, The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way, describes a comprehensive set of insurance, payment, and system reforms that, if implemented together, would produce savings that could offset the federal investment required. The policy recommendations encompass five strategies that the Commission sees as critical to achieving a high-performing health system:
- Extending affordable coverage to all by establishing a national health insurance exchange and offering, in addition to private insurance plans, a new public health plan option to provide more affordable choices for employers and families.
- Aligning incentives in health care payment policies to emphasize value over volume by supporting greater collaboration among providers and more accountability for patient outcomes.
- Promoting accountable, accessible, patient-centered, and coordinated care by moving away from fragmented health care delivery and toward a more organized system that patients can easily navigate, that ensures access to a personal source of care, and that holds providers accountable for quality across the continuum of care.
- Aiming high to improve quality and health outcomes by investing in public health, disease prevention, and health system infrastructure—including health information technology—to improve the availability, quality, and usefulness of information for health care decision-making.
- Ensuring accountable leadership and collaboration to set and achieve national goals by enabling insurance programs to serve as prudent purchasers of care and by putting in place policies that coordinate activities of the public and private sectors.
Impact of Reforms on Coverage
Taken as a whole, the options in the Path report would achieve near-universal health coverage while also ensuring access, improving continuity of care, and lowering insurance premiums. By 2012, the number of uninsured would decline to 4 million people, less than 1 percent of the population. More than 130 million people would have access to more comprehensive and affordable coverage.
Impact of Reforms on Health Spending
The integrated policies modeled in the Path report could slow the rate of growth in national health spending from 6.7 percent to 5.5 percent over the 2010–2020 period. Reducing the growth rate would yield cumulative savings of $3 trillion over the decade, compared with current projections. The savings would accrue to state and local governments, which would save $1 trillion over this period; employers, which would save $231 billion; and families, who would save $2.3 trillion, with households averaging $2,300 in lower annual spending by 2020.
The Path report shows that it is possible to ensure that everyone has coverage, improve health, and significantly slow spending growth. Doing so, however, will require a systems-based approach. And reforms must start now. Especially in the current economic climate, the nation can ill afford ever-increasing health costs, eroding insurance coverage, and quality of care that fails to meet Americans' expectations.
For more information, read The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way (New York: The Commonwealth Fund Commission on a High Performance Health System, Feb. 2009).
This summary was prepared by Rachel Nuzum, M.P.H., senior policy director for The Commonwealth Fund. She works out of the Fund’s Washington, D.C., office and can be reached at firstname.lastname@example.org.