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Fostering Accountable Health Care: Moving Foward in Medicare

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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” »

Mark B. McClellan

Former Brookings Expert

Director, Margolis Center for Health Policy - Duke University


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