AHA: Reform, not lower provider payments, will curb healthcare spending

The American Hospital Association is weighing in on how to reduce healthcare spending, arguing the solution is not to simply cut Medicare and Medicaid reimbursements to providers.

The AHA Board of Trustees' new report, "Ensuring a Healthier Tomorrow: Actions to Strengthen Our Health Care System and Our Nation's Finances," includes 12 recommendations grouped in two main categories:

Promote and reward accountability for the quality and efficiency of healthcare by:

  • Accelerating payment and delivery system reforms to move away from fee-for-service toward integrated models including medical homes, bundled payments and accountable care organizations (ACOs).

  • Eliminating preventable infections and complications.

  • Engaging patients in their health and healthcare.

  • Better managing advanced illness so severely ill patients and their families can make decisions about care with access to comprehensive health and social services.

  • Advancing the use of health IT and electronic health records, including standardizing technologies and achieving interoperability.

  • Improving transparency of quality and pricing to both patients and clinicians.

Use limited healthcare dollars wisely by:

  • Eliminating added treatments that do not improve outcomes.

  • Redistributing care to spend more on socially vulnerable populations.

  • Better managing community health, including management of chronic diseases including obesity, diabetes and heart disease.

  • Updating Medicare and the Federal Employee Health Benefit Program to reflect changes in demographics, life expectancy and service delivery.

  • Simplifying administrative and regulatory processes so providers don't have to spend so much time and money on paperwork.

  • Reforming the medical liability system.

The 17-page report also includes examples of how each of those recommendations can be implemented.

"Real improvements in health and healthcare--as opposed to arbitrary cuts to provider payment--have the ability to put our country on a more sustainable fiscal path," the report concluded, noting hospitals can reform the system on their own.

The AHA is hardly alone in making many of these arguments. Earlier this month, for example, the Nation Commission on Physician Payment Reform recommended phasing out standalone fee-for-service payment models by the end of the decade and replace them with a blended payment system.

Research backs many of the most common arguments. A recent study, for example, found that patients who took an active role in managing their health had healthcare costs 8 percent to 21 percent lower than less-involved patients.

To learn more:
- download the report
- download the executive summary
- here's the AHA announcement