Since the federal government is hampered by political conflict, the states must take the reins when it comes to containing healthcare costs, according to a report from the Center for American Progress, a nonpartisan think tank.
In the report, healthcare policy experts propose the "Accountable Care States" model, an optional program for states that would make them responsible for healthcare costs, quality and access, with financial incentives to keep overall spending down. Participating states would agree to limit growth in total healthcare spending per capita to a target rate based on the state's economic growth per capita. States also wouldn't be allowed to meet their targets through policies that just shift healthcare costs to consumers. Those that hit the spending target — in addition to improving quality and access to care — would share in the federal government's savings from Medicare, Medicaid, Patient Protection and Affordable Care Act premium subsidies and other federal health programs.
Even if only half of the states decided to participate in the model, the U.S. could potentially save $1.7 trillion over 10 years, according to the report. Federal savings would account for more than $350 billion of that amount, while 21 states would earn more than $1 billion in financial incentives. Another 33 states would earn more than $500 million, and 44 would receive more than $200 million.
"Only states have the policy levers and the political will to lead reform, and only the federal government can provide strong enough incentives," the report's authors write in their conclusion. "The Accountable Care States model — which combines these state and federal elements — therefore represents our best hope for sustainable healthcare spending in the coming years."