Health Cost Containment

Topic Outline

1. Improve quality
a. Evidence-Based Medicine
b. Pay-for-performance
c. Bundled payments
d. Capitation
e. Disease management
f. Medical homes
g. Shared savings
2. Improve administration
a. Health information technology (HIT)
b. Reduce excess administrative costs
c. Health benefits management
3. Promote healthy behavior
a. Prevention
b. Health promotion
4. Promote efficient use
a. Cost-sharing
b. Consumer health information
   c. Hospital utilization control
d. Drug formularies
   e. Cost-effective benefits
5. Promote competition
a. Consumer-directed health care
b. Antitrust enforcement
c. Managed competition
   d. Medical tourism
e. Transparency
f. Business coalitions
g. Reference pricing

Insurance-Business Coalitions (Health Affairs topic page)
The Cost Problem: Blue Cross and Blue Shield of North Carolina
See also managed care and consumer-directed health care.
Baicker, K., & Chandra, A. (2010). Uncomfortable Arithmetic — Whom to Cover versus What to Cover. New England Journal of Medicine, 362(2), 95-97. Much of the current debate about expanding health insurance coverage avoids addressing an uncomfortable trade-off: with a limited budget, making benefits more generous means being able to cover fewer people. Moreover, designing insurance benefits that are limited to coverage of higher-value care but are extended to more people will generate greater improvements in health than providing unlimited care for fewer people. Policymakers and patient advocates are reluctant to acknowledge that in a world of scarce resources it will not be enough to eliminate waste: we will have to make active choices in our public insurance programs between increasing the number of people covered and increasing the generosity of coverage.