These resources and links provide opportunities for learning, background, issue discussion and concept development in support of healthcare reform that works for North Carolina.
Understanding and Comparing Health Reform Proposals
The Kaiser Family Foundation
The Rand Corporation
Rand Compare
Wall Street Journal Health-Care Reform Proposals
http://online.wsj.com/public/resources/documents/st_healthcareproposals_20090912.html
Commonwealth Fund
http://www.commonwealthfund.org/Health-Reform.aspx
National Rural Health Association
http://www.ruralhealthweb.org/go/left/policy-and-advocacy/health-reform
NCHA Resources: Key Stats and ANDI
NCHA will analyze the impact of healthcare reform on NC hospitals.
American Hospital Association Resources and Health Reform Advocacy:
Health for Life
http://www.aha.org/aha_app/issues/Health-for-life/index.jsp
AHA Health Reform Update and Advocacy
http://www.aha.org/aha/advocacy/health-reform.html
American Medical Association
Prescription for Healthcare Reform - AMA supports the achievement of meaningful health system reform, which follows six key concepts:
- Expanded coverage
- Improve quality
- Reform government programs
- Reduce costs
- Increased focus on wellness/prevention
- Payment and delivery reforms
Mayo Clinic Health Policy Center
http://www.mayoclinic.org/healthpolicycenter/recommendations.html
Mayo Clinic believes that American health care urgently needs reform to ensure the future of quality patient care. Recognizing that widespread consensus and collaboration will be essential to successful healthcare reform, Mayo Clinic formed its Health Policy Center and hosted an inaugural symposium in May 2006. The Mayo Clinic Health Policy Center convened more than 2,000 stakeholders for a series of events to help develop new, consensus-driven principles and specific action steps to accelerate the reform process.
To reform health care, participants in Mayo Clinic Health Policy Center programs including providers, academics, medical industry leaders, businesspeople, insurers, political leaders and patients - recommend four areas of focus.
- Create Value - Improve patient health outcomes and satisfaction with U.S. healthcare. Decrease medical errors, costs and waste.
- Coordinate Care - To increase value, patient care services must be coordinated across people, functions, activities, locations and time. Patients must actively participate in this process.
- Reform the Payment System - Change the way providers are paid in order to improve health and minimize waste.
- Provide Health Insurance for All - Provide guaranteed, portable health insurance for all individuals, giving them choice, control and peace of mind.
Theda Care Center for Healthcare Value
http://www.createhealthcarevalue.com
Healthcare Delivery Reform Principles:
- Demanding more from healthcare reform
- Encourage transparent comparisons between providers
- Physicians should keep patients well
- Patients must take individual responsibility
American Medical Group Association
http://www.amga.org/Advocacy/hrp.pdf
Summary of Healthcare Reform Principles
- All Americans should have access to healthcare.
- Changes among all payers will be necessary.
- Delivery System Reform - The healthcare delivery system must be transformed from a fragmented non-system to an organized system of care.
- Multi-specialty Medical Groups/Organized Systems of Care - The multi-specialty medical group and organized systems of care delivery model should be supported as a matter of national policy.
- Community-Based Accountability for Healthcare Services - Those who deliver healthcare should be accountable for their services to the communities served.
- Shift Payments from Volume to Value - The healthcare reimbursement system must shift from pay-for-volume to pay-for-value.
- Incentives - should be in place to encourage coordinated care and are needed to expand health information technology.
- Professional Liability (Medical Malpractice) Reform - must be a component of healthcare reform.
- Comparative Effectiveness - must be a component of healthcare reform.
- Prevention and Wellness - Preventive measures and wellness practices should be adopted to address chronic disease and obesity.
- Enhancing the healthcare workforce
- Increase numbers, expand loans and grants, and address payment inequities.
- Transparency in Business Relationships - Those with involvement in patient care should make public their significant financial, ownership, or similar relationships.
Medical Group Management Association
http://www.mgma.com/policy/default.aspx?id=28690
MGMA serves 22,500 members who lead and manage more than 13,700 organizations in which almost 275,000 physicians practice. Its diverse membership comprises administrators, CEOs, physicians in management, board members, office manager and many other management professionals, working in medical practices and ambulatory care organizations of all sizes and types, including integrated systems and hospital- and medical school-affiliated practices.
Commonwealth Fund
A Roadmap To Health Insurance For All
Principles to Consider in Developing and Evaluation Health Reform Proposals:
- Access to Care
- Provides equitable and comprehensive insurance for all.
- Insures the population in a way that leads to full and equitable participation.
- Provides a minimum, standard benefit floor for essential coverage with financial protection.
- Premiums, deductibles, and out-of-pocket costs are affordable relative to family income.
- Coverage is automatic and stable with seamless transitions to maintain enrollment.
- Provides a choice of health plans or care systems.
- Quality, Efficiency, and Cost Control
- Health risks are pooled across broad groups and over life spans; insurance practices designed to avoid poor health risks are eliminated.
- Fosters efficiency by reducing complexity for patients and providers, and reducing transaction and administrative costs as a share of premiums.
- Works to improve healthcare quality and efficiency through administrative reforms, provider profiling and network design, utilization management, pay-for-performance payment models, and structures that encourage adherence to clinical guidelines.
- Minimizes dislocation; people can maintain current coverage if desired.
- Simple to administer.
- Has the potential to lower overall healthcare cost growth.
- Financing
- Financial commitment to achieve these principles.
- Financing should be adequate and fair, based on ability to pay, and is a shared responsibility of federal and state governments, employers, individual households, and other stakeholders.
Commission on a High Performance Healthy System
This report from the Commonwealth Fund Commission on a High Performance Health System offers recommendations for a comprehensive set of insurance, payment, and system reforms that could guarantee affordable coverage for all by 2012, improve health outcomes, and slow health spending growth by $3 trillion by 2020-if enacted now to start in 2010. Central to the Commission's strategy is establishing a national insurance exchange that offers a choice of private plans and a new public plan, with reforms to make coverage affordable, ensure access, and lower administrative costs. Building on this foundation, the report recommends policies to change the way the nation pays for care, invest in information systems to improve quality and safety, and promote health. By stimulating competition and delivery system changes aimed at providing more effective and efficient care, the policies could yield higher value and substantial savings for families, businesses, and the public sector.
Strategies for comprehensive reform:
- Affordable coverage for all.
- Align incentives with value and effective cost control.
- Accountable, accessible, patient-centered, and coordinated care.
- Aim high to improve quality, health outcomes, and efficiency.
- Accountable leadership and collaboration to set and achieve national goals.
Business Roundtable
http://www.businessroundtable.org/
CEOs representing America's leading companies today proposed a healthcare policy plan aimed at delivering more value for consumers, expanding affordable health insurance options for all Americans and ensuring a stable, secure public safety net. The plan would promote changes to make the healthcare system more efficient and transparent to American consumers, while providing more marketplace options for employers and individuals to obtain coverage.
Healthcare policy plan:
- Creating Greater Consumer Value in the healthcare marketplace by using health information technology and empowering consumers with more information about good, quality healthcare.
- Providing More Affordable Health Insurance Options for All Americans by creating an open, all-inclusive private market for health insurance, replacing today's highly fragmented, state-by-state market with multi-state markets. This would create more choices for more healthcare consumers through broader, more competitive markets.
- Placing an Obligation on All Americans to Obtain Health Insurance, either through their employer or the private market. Americans would also be encouraged to participate in employer or community-based prevention and chronic care programs.
- Offering Health Coverage and Assistance to Low-Income, Uninsured Americans, creating a stable and secure public safety net. This assistance would be financed from the cost savings and efficiencies generated by a more competitive and value-driven healthcare system.
The National Business Group on Health
http://www.businessgrouphealth.org/benefitstopics/et_healthcarereform.cfm
The National Business Group on Health is the national voice of large employers dedicated to finding innovative and forward-thinking solutions to the nation's most important healthcare issues. The almost 300 members of the Business Group, primarily Fortune 500 employers, provide health coverage for more than 6 million U.S. workers, retirees and their families.
Principles For Successful National Health Reform:
- Acknowledge the shared responsibility of all, and not just one or a few, of the following groups: individuals, healthcare providers, health insurers, employers, and governments (federal, state and local).
- Encourage everyone to take personal responsibility for their own health.
- Encourage everyone to be personally engaged in their own healthcare.
- Make reliable information to make meaningful comparisons of recommended treatments and treatment alternatives readily available and transparent.
- Require comparative effectiveness studies for new healthcare interventions.
- Create a workable, secure nationwide electronic health information network.
- Ensure the availability of portable personal health records for all.
- Reform the healthcare legal system.
- Direct resources to prevention and needed primary care.
- Target capital spending to underserved areas and truly needed facilities and equipment.
- Promote quality and ensure patient safety.
- Advance evidence-based medicine.
- Expand pay-for-performance in public and private financing systems.
- Recognize the need for a diversity of initiatives to expand coverage, reflecting the diverse needs and characteristics of the uninsured.
- Improve the effectiveness and efficiency of public programs and a strong healthcare safety net.
- Promote a strong, efficient private marketplace for health insurance, particularly in the individual and small group markets.
- Encourage new coverage options.
- Avoid benefit mandates.
- Support tax policies that encourage health coverage, simplify health benefits administration, and support and reinforce healthy behaviors.
- Preserve and strengthen ERISA.
NC Blue Cross and Blue Shield
Principles for Reform:
Strategies for comprehensive reform:
- BCBSNC believes all Americans should have health insurance.
- BCBSNC believes dealing with rising healthcare costs is central to healthcare reform.
- BCBSNC believes the most effective way to improve our healthcare system is to build on the employer-based system.
- BCBSNC believes that government needs to play a role, to assist Americans who today cannot afford health insurance on the private market.
- BCBSNC believes that improving health information technology is a cornerstone of healthcare reform.
- BCBSNC believes in paying doctors and hospitals for quality and health outcomes, rather than for the quantity of procedures they perform.
- BCBSNC believes that private-sector health insurance is better able to bring innovation and quality improvements to healthcare.
- BCBSNC believes a government-run health insurance plan is not necessary to achieve the goals of meaningful healthcare reform.
Americas Health Insurance Plans
http://www.americanhealthsolution.org/
Summary of Campaign for an American Health Solution:
The Campaign for an American Solution is working to build support for a new comprehensive healthcare reform proposal. The new proposal was put together after the Campaign's nationwide listening tour in which Americans from all walks of life shared their personal healthcare stories and ideas and suggestions on how to reform the healthcare system. The Campaign believes the proposal will lead to a stronger healthcare system that will benefit all Americans.
The proposal addresses the concerns the American people by:
- Building on the current employer-based system.
- Making common-sense changes to reduce healthcare costs.
- Strengthening the healthcare safety net.
- Providing a helping hand for working families and small businesses.
- Guaranteeing coverage for everyone.
- Improving the quality and value of medical care.