State of the Union: Health care debate continues

Despite reassurances from the President in Tuesday’s State of the Union Address that the Affordable Care Act will slow rising health care costs, debate on the health care law didn’t skip a beat come Wednesday morning on Capitol Hill. The House Budget Committee is holding hearings this week to evaluate the economic impact of health care reform. On Wednesday the testimony of the CMS Actuary garnered quite a bit of attention when he expressed his doubt that the law will be able to bring down unsustainable health care costs. The White House was quick to respond with a post by Stephanie Cutter pointing out key elements of the law which independent experts have argued will result in cost savings. Notably, Cutter highlights both payment reform and the creation of Accountable Care Organizations to coordinate care as a means to improve health care quality and efficiency. These same sentiments are echoed in a letter released on Wednesday which was signed by over 200 health care leaders stating that the Affordable Care Act contains almost every cost-containment provision that is considered effective at reducing health care costs. The letter counts increased emphasis on wellness and prevention as one of the effective cost containment measures in addition to models of coordinated care and rational reimbursement.
We at the Center believe that providing smarter health care can both improve quality and decrease costs. Although there are a staggering number of variations on the theme of coordinated care, pilot projects in patient populations have shown considerable cost savings in a number of such projects. This is particularly true in populations with heavy burdens of chronic disease, whose inherently high disease costs provide an equally high potential to save costs over conventional approaches to care. My colleagues and I published a piece in Academic Medicine back in November discussing how personalized medicine provides a standardized approach to overcome impediments to both coordination of care and rational reimbursement. As a model of health care which is equally effective at disease prevention and treatment, prospective health care provides an approach on which to base many of these cost containment measures.