Can insurers really achieve better care at lower costs?


There's no mistaking the fact that healthcare costs continue to rise regardless of whether quality of care improves. So a new study from the Commonwealth Fund examines if it's possible to get better care at lower costs, analyzing several payment reform initiatives already underway.

"We know for certain that more spending does not translate into better care or a better-functioning healthcare system," the study states. "The good news is that a lot of activity is already taking place in the private and public sectors to obtain greater value for our health care dollars."

The most successful strategies to improve care and lower costs include encouraging providers and patients to make good healthcare choices, expanding access to medical homes and primary care, and promoting an increased use of technology.

Some of the most promising initiatives to provide a high-quality, affordable health system, according to the study, are:

  • Global payments: Under this payment model, insurers give a single healthcare organization one sum to provide all the care for a specific population, such as one company's employees or all people living in a certain geographic area. In addition to saving money, doctors focus on meeting certain quality standards and receive bonuses when patients avoid expensive hospitalizations. Some of the most well-known global payment initiatives come from insurers in Massachusetts, including Harvard Pilgrim and Blue Cross Blue Shield of Massachusetts, that pay providers a fixed amount of money each year to care for patients. However, a 2011 report concluded these global payments weren't saving money.

To learn more:
- here's the Commonwealth Fund study

Related Articles:
Bundled payments gain momentum among insurers, providers
What 6 health plan execs have to say about new payment, delivery models
BCBSNC bundles payments for better coordination, quality, costs
Harvard Pilgrim reaches global payment deal with Partners HealthCare
Global payments aren't saving money in Massachusetts
Fierce Q&A: A look at Cigna's ACO program
Cigna's Dick Salmon shares collaborative care insights