In 2013, at least 10 organizations or coalitions developed comprehensive strategies to contain health care costs, in anticipation of potential entitlement or tax reform. Consistently, the proposals developed by the groups call for reengineering the health delivery system with a diminished role for fee-for-service payment.
While the shared vision of the diverse groups provides an opportunity for policy development, there are obstacles to adoption, including the nascent state of many payment reform approaches and a lack of provider readiness to increase clinical integration and coordinate care. Meanwhile, unresolved political issues around the scope of entitlement and tax reforms pose a significant barrier as well.
This article reviews the cost-containment approaches developed by 10 featured organizations or coalitions, identifies barriers to effective cost-containment strategies, and points to the most promising ways forward.