Without major changes in the way the U.S. pays for and delivers health care, total national health spending is projected to rise to $4.6 trillion—or nearly 20 percent of GDP—by 2020. In a new blog post, Commonwealth Fund president Karen Davis says policymakers looking for savings should "go where the money is," and focus on improving care for patients with multiple, high-cost conditions. The post is based on a presentation she gave at a Washington, D.C., briefing cosponsored by the Alliance for Health Reform and The Commonwealth Fund.
Davis highlights a number of projects that have improved quality and reaped savings, including several state-based Medicaid initiatives to create patient-centered medical homes; initiatives aimed at avoiding rehospitalizations; and international examples of chronic care management and after-hours care systems as an alternative to emergency room use.