National healthcare spending could be reduced by 5.4 percent between 2010 and 2019 by bundling payments for the treatment of chronic diseases and applying the model to all payers, not just Medicare, according to an article published in the Nov. 11 issue of The New England Journal of Medicine. Researchers point out the Congressional Budget Office (CBO) estimate of savings achievable through payment bundling, which was much lower (0.05 percent), reflected only hospital and post-acute care services paid for by Medicare.
“The difference between the CBO’s estimates and ours illustrates the limits of focusing solely on savings in the federal budget,” researcher Peter Hussey wrote.
The Rand Health research team identified eight options that evidence suggests have the potential to reduce spending and are broadly applicable to the United States. For each option, they developed high and low estimates of cumulative cost savings over 10 years. Other options that were analyzed include hospital-rate regulation, health IT, disease management, medical homes, retail clinics, extending mid-level practitioners’ scope of practice, and changing benefit design.
