Total U.S. healthcare spending could be reduced by an estimated $145 billion by 2015 if a plan proposed by America's Health Insurance Plans is followed, says PricewaterhouseCoopers.
The proposal calls for five core principles to "ensure that patients receive high-value healthcare."
"Based on our analysis, these initiatives, if implemented broadly, can yield significant savings," said Jack Rodgers, director of Health Policy Economics at PricewaterhouseCoopers.
According to AHIP, the initiative is part of an 18-month effort to present a roadmap that offers comprehensive solutions to address the nation's healthcare crisis.
Widespread technology, interoperability and the adoption of a strong and uniform security and privacy system are needed in order to achieve a better system and the estimated savings by 2015, according to Rogers.
According to AHIP, the savings would be found in comparative effectiveness research ($5 billion), health information technology ($37 billion), medical liability reform and defensive medicine ($45 billion), value-based reimbursement ($11 billion) and disease management, chronic care and prevention ($47 billion).
The five principles and proposals, as provided by AHIP, are:
- Patients and their doctors must have the information and tools they need to evaluate treatment options and make health care decisions on the basis of safety, quality and cost.
AHIP Proposal: Access to information that compares the effectiveness and cost of treatments; give providers, patients and purchasers access to a trusted source where they can find up-to-date and objective information on which health care services are most effective and provide the best value.
- Patients and doctors want an efficient, interconnected health care delivery system that reduces medical errors.
AHIP Proposal: With regard to ealth information technology, encourage widespread adoption of tools such as electronic health records (EHRs), personal health records (PHRs), secure e-visits with physicians and e-prescribing.
- Doctors and nurses need the freedom to practice medicine without worrying about frivolous lawsuits.
AHIP Proposal: Reform the legal system be replacing the current medical liability system with a dispute resolution process consisting of an objective, independent administrative process to provide quick and fair resolution to disputes while promoting evidence-based medicine.
- Health insurance plans are transitioning to a system that more closely aligns payments with the quality of care patients receive.
AHIP Proposal: Build health care reform around quality improvement by rewarding safety, value and effectiveness; work for the broader adoption of value-based reimbursement mechanisms and provide consumers with more actionable information about health care value.
- The nation must move toward a system of care that focuses on keeping people healthy, detects disease at the earliest possible stage and rewards chronic care management.
AHIP Proposal: Enhance disease management, care coordination and prevention programs by deploying a new generation of strategies that emphasize prevention, improve chronic care and tailor healthcare for patients to help them live longer and stay healthier.
"The goal is to keep people healthy and health insurance plans have pioneered the next generation of cost containment strategies necessary to advance this objective," AHIP President Karen Ignagni said. "Health insurance plans have made measurable progress, but the nation needs a coordinated approach across the public and private sectors to maximize the impact of these strategies."