Skip to main content
Article

Fostering Accountable Health Care: Moving Foward in Medicare

Elliott Fisher, Mark B. McClellan, John Bertko, Julie J. Lee, Julie L. Lewis, and Jonathan Skinner

Abstract: To succeed, health care reform must slow spending growth while improving quality. We propose a new approach to help achieve more integrated and efficient care by fostering local organizational accountability for quality and costs through performance measurement and “shared savings” payment reform.

The approach is practical and feasible: it is voluntary for providers, builds on current referral patterns, requires no change in benefits or lock-in for beneficiaries, and offers the possibility of sustained provider incomes even as total costs are constrained. We simulate the potential expenditure impact and show that significant Medicare savings are possible.

Read the Health Affairs Web Exclusive, “Fostering Accountable Health Care: Moving Forward in Medicare” »

Authors

Mark B. McClellan

Former Brookings Expert

Mark McClellan is a senior fellow and director of the Health Care Innovation and Value Initiative at Brookings. He has written a number of publications on care delivery reform, physician payment reform, and accountable care implementation in the U.S. and abroad.

J

John Bertko

Guest Scholar, Engelberg Center for Health Care Reform

More

Get daily updates from Brookings