WIHI: Slowdown in the Growth of US Health Care Spending

​Date: July 11, 2013


  • Donald Berwick, MD, MPP, FRCP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; Former Administrator, Centers for Medicare & Medicaid Services (CMS)
  • David Cutler, PhD, Otto Eckstein Professor of Applied Economics, Harvard University, Harvard Kennedy School of Government, Harvard School of Public Health
  • Amitabh Chandra, PhD, MA, Professor of Public Policy and Director of Health Policy Research, Harvard Kennedy School of Government; Member, Congressional Budget Office’s Panel of Health Advisors
Is the rate of growth of health care spending slowing in the US? And, if so, to what do we attribute this momentous development? Momentous because a lot of health economists and policy makers believe there’s something to the decline besides the impact of the recent US recession. And, for the first time, there are indications that pressure from both public and private payers, reinforced by reimbursement reforms rolling out in the Affordable Care Act, may be making a dent in the growth of the country’s health care spending. It’s way too soon to cheer, but it isn’t too soon to gather some smart people together to try and tease out what’s going on.

Guest Don Berwick talks about some of the initiatives he helped shape and enact while at the Centers for Medicare & Medicaid Services (CMS), designed to move the system toward global budgets and shared responsibility for populations. Are these shared-savings programs starting to have a slowing effect on the growth of health care spending? Well-known economist David Cutler discusses his recent findings that there could be a $770 billion windfall coming for Medicare and Medicaid over the next decade, that wasn’t foreseen and wasn’t part of cost projections. Amitabh Chandra is watching recent spending trends closely, too, and helps us think through whether any of them are linked to greater efficiencies, less waste, and better ways to deliver care.

WIHI's Communications Coordinator John Gauthier highlighted some of the key questions that listeners posed here in a blog post. Take a look and then listen to the broadcast to hear what our guests had to say.
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