Stakeholders' Health Reform Letter to Obama Offers Few Specifics

Janice Simmons, for HealthLeaders Media , June 2, 2009

After meeting at the White House three weeks ago, members of the six healthcare organizations that promised to find ways to save $2 trillion over the next decade—by decreasing by 1.5% the annual healthcare spending growth rate—yesterday sent their game plan "to bend the cost curve" in the form of a 28-page letter to the White House.

After convening seven all-day meetings and multiple conference calls, the group came up with the following projected savings:

  • Utilization of care ($150 to $180 billion)
  • Chronic care ($350 to $850 billion)
  • Administrative simplification and the cost of doing business ($500 to $700 billion)

Individualized savings are not specifically included in the sections submitted by the groups.

While it's likely that their proposals could be considered during healthcare reform discussion on Capitol Hill, the idea of whether the plan would actually work is drawing questions. "I'm skeptical that these proposals will add up to anywhere near $2 trillion," Sen. Charles Grassley, the ranking minority member of the Senate Finance Committee, said in a statement yesterday.

American Hospital Association President and CEO Rich Umbdenstock, said in a separate statement that the groups will implement selected initiatives "individually and collaboratively."

AHA said it will launch a national campaign—"Hospitals in Pursuit of Excellence"—to "build upon quality improvement efforts that are already underway in the industry." These include initiatives, such as reducing surgical infections and complications, reducing pressure ulcers, and reducing adverse drug events from high-hazard medications.

Each hospital will choose which issues on the list are the next for it to tackle, but the "most important objective will be accelerating the pace of improvement while broadening and deepening the success" across the field, Umbdenstock said. The group also cited focusing on longer-term initiatives, such as improving care coordination, implementing health information technology, preventing patient falls, and reducing supply costs.

The American Medical Association called for actions that reduced variations in care and improved quality of care, which emphasized appropriate utilization of healthcare services and treatments. The group proposed as the areas of focus:

  • Reduction of hospital admissions within 30 days of initial discharge
  • Reduction in the overuse of certain procedures (such as surgical and nonsurgical management of back pain and use of antibiotic prescription and sinus radiography with sinusitis)
  • Use of medication reconciliation

America's Health Insurance Plans called in part for administrative simplification that would overhaul and automate "five key" functions—claims submissions, eligibility, claims status, payment, and remittance. AHIP also called for expanded use of personal health records and improving health literacy.

The other groups signing in on the plans are the Pharmaceutical Research and Manufacturers of America, the Service Employees International Union, and the Advanced Medical Technology Association.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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