On April 19, 2013, the Washington, DC–based Bipartisan Policy Center (BPC) released a comprehensive report with several recommendations for reducing the cost and improving the quality of health care in the United States. Funded by the Peter G Peterson Foundation and the Robert Wood Johnson Foundation, the report was part of the BPC’s Health Care Cost Containment Initiative, which was led by four government veterans: former Senate majority leaders, Tom Daschle and Bill Frist; former chairman of the Senate Budget Committee, Pete Domenici; and former White House Office of Management and Budget director and first director of the Congressional Budget Office, Dr. Alice Rivlin. The report was coauthored and reviewed by BPC Health Project directors, Katherine Hayes and William Hoagland, along with other staff and seasoned health policy experts, such as Paul B. Ginsburg, Chris Jennings, Sheila Burke, Steven Lieberman, and Joe Minarik.
What makes this initiative unique, the authors say, is its bipartisan approach and a focus that extends beyond just “federal health-costs and deficit reduction.” In a Washington Post op-ed, Daschle, Frist, Domenici, and Rivlin point to the report’s more than fifty major policy recommendations and an estimated $560 billion in debt and deficit reduction over the next decade. That savings, they say, “is the outgrowth of our work, not the goal.” The chief lesson is: “Until better care is prioritized over more care, our nation will continue to face a problem with health-care costs.” They admit there is no silver bullet and “[n]o single set of recommendations can fix the health-care system or the nation’s debt and deficit crisis overnight,” but they hope “this report can start a constructive, pragmatic dialogue among policymakers and political leaders”.
The report divides its recommendations into four core areas: Medicare (payment and delivery structural changes), tax-reforms (alternatives to the Cadillac-tax and Health Insurance Providers Fee), other federal policies (prevention, public health, and measuring value over volume), and, finally, state-led policy reforms (with a focus on safety-net population and workforce issues).
The report, as a whole, proposes both major and minor tweaks to the Affordable Care Act. It calls for policy makers to invest in accountable care organizations and bundled payments, repeal the sustainable growth rate, strengthen health information technology, and support graduate medical education. The broad range of suggestions also includes greater investments in public health cost-efficiency studies, standards for measuring quality, and demonstration projects that push for prevention strategies and improve care offered to Medicaid enrollees.
On May 31, 2013, the BPC’s Health Project directors sent a letter to Senate Finance Committee Chairman Sen. Max Baucus reiterating a number of recommendations from the report, including repealing Medicare’s sustainable growth rate formula and strengthening accountable care organizations. The BPC estimates its recommendations could save the Medicare program $300 billion over 10 years.