WIHI: The Ups and Downs of Health Care Costs and Reform

Date: February 12, 2015


  • Donald M. Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement
  • David Cutler, PhD, Otto Eckstein Professor of Applied Economics, Harvard University, Harvard Kennedy School of Government, Harvard School of Public Health

There are lots of health care issues to speculate about in the coming year. Here in the US, the ongoing expansion of health insurance coverage is an ambitious work in progress that continues to face plenty of political and legal headwinds. And then there’s the still glaring and still growing $3 trillion national price tag of US health care. Some are encouraged that health spending is slowing, but do we have any strong evidence that improvements in the quality of care, safety, and IT, coupled with payment reforms that increasingly tie reimbursements to quality and value, are key factors?

Fortunately, our guests on this WIHI, Don Berwick and David Cutler, bring important improvement, policy, and economic perspectives to the table to help make sense of the current environment and what’s ahead.

Against the backdrop of the Affordable Care Act and other significant initiatives, our guests offered their assessments of recent progress with better care and lower costs, and where efforts need to continue to yield even bigger benefits. We also touched upon the following: global payments and the various payer-led financial carrots and sticks in play right now designed to improve health care delivery; the state of statewide reforms, Medicaid expansion, and community-led, population health-driven experiments; and the bright spots and storm clouds on the horizon with respect to policy makers, politicians, and the public where there are still major divides.


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