Health Savers Initiative

The Health Savers Initiative is a collaborative project of the Committee for a Responsible Federal Budget, Arnold Ventures, and West Health which works to identify bold and concrete policy proposals to make health care more affordable for the federal government, businesses, and households.

The purpose of the Health Savers Initiative is to develop policy-ready options that will lower health care costs economy-wide, reduce the cost of health care and its impact on families, and save money for the federal government. For each option, we produce an issue brief along with federal budget and national health expenditure impact scores. The option presented in each brief is meant to be just one of many, but we incorporate specifications and savings estimates so policymakers can weigh costs and benefits, and gain a better understanding of whatever health savings policies they choose to pursue.

The project is led by Josh Gordon, Director of Health Policy at the Committee for a Responsible Federal Budget. 

Health Savers Initiative Briefs:

Reducing Medicare Advantage Overpayments: This brief addresses overpayments to private insurance plans in the Medicare Advantage program that reduce market incentives for innovation by allowing plans to profit from the overpayments rather than through improvements in quality and efficiency. (For updated projections, see here)

(NEW) Employer Plans in Medicare Advantage: A Flaw in the Quality Bonus System: This brief points out some problems with, and costs of, the Medicare Advantage quality bonus program. These are illuminated by looking at features of Employer Group Waver Plans (EGWPs) in Medicare Advantage which give them an advantage in garnering bonuses. 

Equalizing Medicare Payments Regardless of Site-of-Care: This brief addresses the fact that Medicare payments for similar procedures vary widely based on site-of-service, incenting provider consolidation and driving up costs for the federal government and the private sector. 

Moving to Site Neutrality in Commercial Insurance Payments: This brief looks into site-of-service payment differentials in commercial insurance as they drive service provision to higher-cost sites – primarily hospital-based outpatient departments (HOPDs) and incentivize hospitals to purchase physician practices. This vertical integration increases the market power and name recognition of health systems, allowing them to demand even higher prices from commercial payers.

(NEW) The Federal Tax Benefits for Nonprofit Hospitals: This brief provides an estimate of the federal revenue loss from the tax advantage given to nonprofit hospitals. It also reviews the evidence that those hospitals are not delivering the "community benefits" they are supposed to provide in exchange for their tax status and provides some suggestions for reforms.

Capping Hospital Prices: This brief addresses the high hospital prices paid by commercial insurance plans. On average, commercial plans pay more than twice as much as Medicare, with some hospitals charging three or four times as much. Those commercial prices are fueled by several factors, including increasing market consolidation and “must-have” hospitals using their market power to negotiate higher prices. 

Injecting Price Competition into Medicare Part B Drugs: This brief addresses the misaligned incentives in Medicare payments for physician-administered drugs that blunt price competition and advantage higher-priced drugs — especially within drug classes that have clinically comparable options but a wide variation in prices.

Limiting Evergreening for Name-Brand Prescription Drugs: This brief addresses the Food and Drug Administration's (FDA) temporary market exclusivities for new brand-name drugs. These exclusivities prohibit generic drug competitors from accessing the market for a limited period. However, drug manufacturers are often able to take advantage of the current rules, using “evergreening” strategies to extend their exclusivity periods and either delay generic drug market entry or limit the number of patients who switch to a new generic.

Blog Post: New Evidence Suggests Even Larger Medicare Advantage Overpayments

Journal Article: "6 Ways to Reduce Health Care Costs," Milken Institute Review, April 2023.

Blog Post: Site-Neutral Payments Would Lower Private Health Costs, Encourage Competition

Blog Post: Two Ways to Reduce Prescription Drug Costs

Blog Post: Three Ways to Lower Health Care Costs

Event: Health Solutions Summit

With the cost of health care rising and the Medicare trust fund quickly approaching insolvency, experts came together to discuss policy solutions for the next Congress to consider. 

Event: New Ideas to Lower Health Care Costs

To mark the publication of the first three Health Savers Initiative briefs, we hosted an event that featured remarks from Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID), and a panel of experts discussing necessary policy interventions that should be on the health care policy agenda.

Launch Event: Opportunities for Lowering Health Care Costs

The project launched on November 21, 2019, with an event that discussed current proposals and new ideas to slow the growth of health care spending, including a discussion of high prescription drug prices, surprise medical billing, and the rising cost of health care for families, businesses, and the federal government.

We were joined by Senate Finance Committee Chairman Chuck Grassley (R-IA), Ranking Member Ron Wyden (D-OR), and committee member Senator Maggie Hassan (D-NH). Our event also featured two panels of experts.

Release: Committee for a Responsible Federal Budget and West Health Launch Health Savers Initiative

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