Commonwealth Fund proposes public-private healthcare model

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To foster "game-changing" innovation in the U.S. healthcare system, federal, state and local leaders must partner with private sector stakeholders in using the new authorities available under the Patient Protection and Affordable Care Act (PPACA) and other federal statutes, according to an April report from the Commonwealth Fund.

“Doing so will not only realize much-needed savings in federal and state budgets, but it will also improve the health, well-being and financial security of millions of patients and their families,” the New York City-headquartered private foundation added.

The report, “The Performance Improvement Imperative: Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients,” proposed the U.S. create 50 to 100 voluntary "health improvement communities" over the next 12 months focused on patients with multiple, high-cost chronic conditions to improve quality of care.

The selected communities should receive both seed funding and regulatory relief in support of program goals, according to the organization. This should include waivers enabling close coordination between Medicare and Medicaid, so as to optimize care for dually eligible patients, and encouraging the participation of private payors to help align incentives and support local action. "Additional financial resources and technical support should be made available to communities that express an interest in participating but are not initially selected."

“The potential savings from improving care for high-cost chronically ill patients are significant,” the report stated. “Recent research undertaken by the Urban Institute for The Commonwealth Fund found building on the reforms contained in the PPACA to improve care for the chronically ill has the potential to save $306 billion over the 10-year period from 2013 to 2022.

“If 50 to 100 Health Improvement Communities are established, it is possible to achieve $184 billion in national health expenditure savings from the recommended combination of new payment strategies to advance the patient-centered medical home model of primary care and to encourage providers to be more accountable for the cost and quality of the care they deliver,” the report concluded. “These savings would account for 21 percent of the $893 billion in reduced national health spending proposed above as a system wide target.”